Solid and cystic papillary epithelial neoplasm of the pancreas in an 11-year-old girl: imaging features with pathological correlation

The diagnosis and management of solid pseudopapillary epithelial neoplasm of the pancreas in a resource-limited setting: two cases from Cameroon

Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a rare tumor of low malignant potential that occurs most often in young females. Imaging and histopathology are necessary to confirm the diagnosis as most have no symptoms. Lack of access to these technologies in sub-Saharan Africa contributes to the difficulty in making an early and accurate diagnosis, and hence, impedes treatment. We present two cases of SPEN of the pancreas in young female patients at a rural, teaching hospital in Cameroon. The diagnosis was made only with histopathology. Computed tomography scan with intravenous contrast was essential to planning a safe surgical resection. Both patients had complete surgical resection with good results.

Clinicopathological features of solid-pseudopapillary tumor of the pancreas: an analysis of 14 cases

AIM: To analyze the clinicopathological and immunohistochemical features of solid-pseudopapillary tumors of the pancreas (SPTP).

METHODS: The clinicopathological and immunohistochemical data of 14 SPTP patients and 5 islet cell tumor patients (including 3 cases of non-functional islet cell tumors and 2 cases of functional islet cell tumors) were analyzed retrospectively.

RESULTS: The ratio of male to female in 14 SPTP patients was 1:6. Their median age was 28 years old. The median diameter of the tumors was 7.25 cm. Histologically, the tumors were composed of pseudopapillary and solid structures. The solid areas were composed of uniform cells. The pseudopapillary structure with a fibrovascular core was remarkable. Immunohistochemically, the tumors were negative for E-cadherin and chromogranin A, but positive for β-catenin and CD10. The positive rates of nuclear and cytoplasmic β-catenin staining in SPTP were 100% and 78.5% (11/14), respectively. In contrast, no membrane β-catenin staining was detected.

CONCLUSION: SPTP is a rare type of tumor that has low malignant potential and remarkable pseudopapillary and is predominantly found in young women. Abnormal E-cadherin and β-catenin expression may be related to the tumorigenesis of SPTP.

Downsizing to resectability of a large solid and cystic papillary tumor of the pancreas by single-agent chemotherapy

Solid and cystic pseudopapillary tumor (SCPT) is an uncommon cancer that typically affects young women. Most patients with SCPT have a favorable prognosis provided a complete resection is attained. There are anecdotal reports of the use of neoadjuvant chemotherapy or radiation therapy for patients with unresectable tumors. We report the case of a 14-year-old female with SCPT who was successfully downsized with gemcitabine before definitive surgical resection.