Pseudopapillary tumor of the pancreas in a 17-year-old girl

A Case of Solid Pseudopapillary Tumor of the Pancreas

We report a rare case of solid pseudopapillary neoplasm in a 24-year-old woman, who presented with progressively worsening left epigastric and right lower quadrant abdominal pain for several weeks. A CT scan showed a mass in the tail of the pancreas that extended to the hilum of the spleen. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) and immunohistochemical analysis exhibited findings pathognomonic for solid pseudopapillary neoplasm. The patient underwent distal pancreatectomy and splenectomy. Post-surgical biopsy confirmed the FNA findings, with the tumor confined to the pancreas and no extension to nearby structures. The patient did not require any other adjuvant therapy. She was asymptomatic at the one-month follow-up and showed no signs of disease. We discuss the unique circumstances of this case and highlight the importance of differentiating this tumor from other pancreatic neoplasms.

Frantz's Tumor in Focus: The Tale of a 34-Year-Old Yemeni Female Patient

A solid pseudopapillary tumor (SPT) of the pancreas, which mainly occurs in young women, is an uncommon pancreatic tumor that often presents diagnostic and therapeutic dilemmas. This case study discusses the symptoms and treatment approach for a 34-year-old woman from Yemen diagnosed with SPT. The patient was diagnosed through abdominal and pelvis CT scan, followed by ultrasound-guided biopsy confirming the presence of SPPT. Management through the Whipple procedure and portal vein reconstruction proved successful, with no recurrence or metastasis noted in a year-long follow-up. The importance of comprehensive understanding and surgical expertise in handling SPT is emphasized.

Central pancreatectomy: A viable option for solid pseudopapillary neoplasm - A case report

INTRODUCTION

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors, comprising about 1 % of pancreatic tumors. They primarily affect females during their reproductive phase and have a favorable prognosis. SPNs are usually asymptomatic or present with mild symptoms. The exact histopathogenesis of SPNs remains unknown. Surgical resection is curative, and central pancreatectomy is a pancreas-sparing surgical technique.

CASE PRESENTATION

A 33-year-old female presented with epigastric pain, vomiting, and infertility. Imaging revealed a mass in the pancreas. Exploration confirmed the mass, and central pancreatectomy was performed. Histopathology confirmed the diagnosis of SPN. The patient's recovery was uneventful, and follow-up CT scans showed no recurrence.

DISCUSSION

This case involves a 33-year-old female presenting with epigastric pain and vomiting, revealing a cystic mass with a solid component in the pancreas. While generally benign, SPNs can become malignant in 15 % cases, with a favorable prognosis. Histopathologically, SPNs remain distinct, with CD99 and CD10 staining confirming the diagnosis. Diagnostic imaging, particularly CT scans, aids in identifying SPNs. Surgical resection, such as central pancreatectomy, is effective, preserving organ function. The case's positive outcome aligns with an overall 5-year survival rate of 95-97 %, highlighting the overall favorable prognosis of SPNs. The procedure's balance between tumor removal and organ preservation offers clinical advantages.

CONCLUSION

This case underscores the successful management of an SPN using central pancreatectomy. It highlights the importance of early diagnosis and surgical intervention, as well as the favorable prognosis associated with SPNs, even in cases of metastasis. Central pancreatectomy offers organ preservation and reduces long-term complications. Continued reporting and research on such cases contribute to refining treatment strategies for SPNs.

Diagnosis and surgical management of a rare neoplastic entity: Solid Pseudopapillary Neoplasm of the Pancreas

INTRODUCTION AND IMPORTANCE

Solid Pseudopapillary Tumors of the Pancreas is an extremely rare pancreatic neoplastic entity that makes up barely 3 % of all types of exocrine pancreatic neoplasia. Symptoms vary and none of them are specific or pathognomonic for the disease. Therefore, delayed treatment or misdiagnoses could be the result. In turn, patients' morbidity and mortality significantly rise. Diagnosing or suspecting this type of critical type of neoplasia in the preoperative phase is a key component to performing appropriate and curative surgical interventions that result in increased patient survivability.

CASE PRESENTATION

We hereby present the rare case of a previously healthy 20-year-old female whose chief complaints were chronic epigastric and left hypochondriac region pain and discomfort along with loss of appetite. During our preoperative radiological investigation, we found a cystic mass with well-defined borders located between the head of the pancreas and the second part of the duodenum. It measured (63 × 45 mm). No metastasis or lymph node involvement was elicited.

CLINICAL DISCUSSION

The tumor was utterly resected via a successful Whipple procedure. A definitive diagnosis of a Solid Pseudopapillary Tumor was reached following meticulous histopathological and immunohistochemical analysis of the resected specimens.

CONCLUSION

Based on our review of the published literature, no previously published cases from our country of pancreatic Solid Pseudopapillary Tumors exist. Documentation of this rare neoplasia is warranted to raise awareness and to establish the necessary clinical protocols to optimally diagnose, timely treat, and adequately follow up on patients who present with this malignancy.

Pancreatic solid pseudopapillary neoplasm with concomitant left unilateral renal agenesis and bicornuate uterus: a case report

A solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor of the pancreas. Concomitant SPN with urogenital anomalies is a very rare presentation.

Case Presentation

A 16-year-old female presented with a chief complaint of abdominal pain 30 days back. Solid pseudopapillary neoplasm (SPN) of the pancreas was diagnosed with the aid of ultrasonography and contrast-enhanced computed tomography of the abdomen and pelvis. Incidentally, concomitant left unilateral renal agenesis and bicornuate uterus were also detected in radiological findings. The patient underwent spleen-preserving distal pancreatectomy, and SPN was confirmed with the histopathological report.

Discussion

Symptomatic SPN patients present with an abdominal mass and pain or very rarely jaundice. Most of the SPNs are benign. Complete surgical excision results in more than 95% cure. SPN with concomitant urogenital anomalies is extremely rare, and their concurrent occurrence can be better attributed to Wnt signaling pathway owing to their similar pathogenic mechanism.

Conclusion

The solid pseudopapillary tumor has an excellent prognosis if timely resected. Proper evaluation of the patient with imaging is necessary to suspect and diagnose SPN who has urogenital anomalies and vice versa.

Solid Pseudopapillary Neoplasm of the Pancreas: A Case Report of a Rare Tumor Detected by Sonography

This case presentation describes a solid pseudopapillary neoplasm found in a young 41-year-old female. This mass was initially detected with sonography and later confirmed with an ultrasound-guided biopsy. The neoplasm was scheduled to be surgically resected, as a cure, which has a favorable long-term prognosis. This case provides information on the imaging characteristics and natural history of this benign neoplasm.

Solid Pseudopapillary Neoplasm of the Pancreas Presenting With Gastric Outlet Obstruction

Solid pseudopapillary neoplasm (SPN) of the pancreas are rare tumors accounting for a minor portion of all exocrine pancreatic tumors. It usually occurs in young women. It has a very low malignant potential with a relatively indolent clinical course. A small subset of patients exhibits pathological features of malignancy. Herein, we present a rare case of pancreatic SPN that presented with gastric outlet obstruction. Despite the characteristic computed tomography (CT) findings, due to its rarity, it was missed in more common conditions such as gastrointestinal stromal tumors. In our case, we found that the tumor was causing extrinsic duodenal compression leading to gastric outlet obstruction, creating a diagnostic dilemma.

Solid pseudopapillary neoplasm of pancreas presenting after bicycle handlebar injury: diagnostic pitfalls in a young female-A case report

Introduction and importance

Solid pseudopapillary neoplasm (SPN) of pancreas is a rare neoplasm with very low malignant potential. It mainly affects females in third decade of life and has favourable prognosis.

Case presentation

We report a case where a 17-years old girl presented with history of blunt abdominal trauma with handlebar of bicycle 6 months back, following which she developed abdominal pain and fullness in epigastrium. Keeping pancreatic pseudocyst as provisional diagnosis, she was investigated. The final diagnosis of SPN of pancreas came as a surprise.

The mass, about 6x5cm, was excised and Roux-en-Y distal pancreatico-jejunostomy was done.

Clinical discussion

Patient showed no recurrence or metastasis till one year of follow-up. This is the first case report of SPN presenting after handlebar injury.

Conclusion

Timely and adequate resection provides good long-term survival.

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Solid pseudopapillary neoplasm (SPN) of pancreas is a rare neoplasm with very low malignant potential and favourable prognosis.

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It mainly affects females in third decade of life and constitutes 2% to 3% of all pancreatic neoplasms and 0.9% to 2.7% of all exocrine pancreatic neoplasms

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Bicycle handlebar injury is the most common cause of pancreatic trauma in children and adolescents and rarely develops in to SPN.

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Surgical resection is the treatment of choice for these tumours even in case of metastasis.

Pseudopapillary Tumor of the Pancreas: A Rare Cause of Extrahepatic Portal Hypertension

A solid pseudopapillary tumor (SPT) of the pancreas is an uncommon neoplasm, characterized by a well-encapsulated mass, with low malignant potential. It occurs predominantly in young females. We present a case of SPT of the pancreas which presented with sinistral portal hypertension. Despite characteristic radiological findings due to its rarity, it may be missed to more common conditions like peptic ulcer disease. Delayed diagnosis can lead to complications like portal hypertension. To the best of our knowledge, in existing medical literature, SPT of the pancreas in males has rarely been described. In our case, we found that the tumor was causing extrahepatic portal hypertension which is also a very unique presentation of this tumor. Due to its vague clinical manifestations, definitive diagnosis is often a challenge hence requiring prompt investigations.

Solid Pseudopapillary Tumor of the Pancreas in a 25-Year-Old Female: A Rare Entity of Pancreatic Tumors

Solid pseudopapillary neoplasms (SPMs) of the pancreas are extremely rare tumors of the pancreas that typically affect young women and have a favorable prognosis. Herein, we report a 25-year-old female with solid pseudopapillary tumor of the pancreas who presented with atypical epigastric pain. The patient underwent pancreatoduodenectomy (Whipple procedure). She remained asymptomatic and showed no signs of disease after one year of follow-up. This type of pancreatic tumors is amenable to cure after complete surgical resection, even in cases with capsular invasion, unlike any other malignant tumors of the pancreas.

Solid pseudo-papillary tumor of the pancreas: Diagnosis by endoscopic ultrasound-guided fine needle aspiration cytology and immunocytochemistry

Pseudopapillary tumor (SPT) is a rare primary pancreatic neoplasm of uncertain origin and low malignant potential that typically affects young females, mostly in their third decade of life. There are only a few reports on fine needle aspiration (FNA) cytology diagnosis of this neoplasm. We report one such case which was diagnosed based on cytomorphologic and immunocytochemical features on endoscopic ultrasound (EUS) guided FNA smears. A 24-year-old woman presented to the gastroenterology clinic with 3-month history of epigastric pain, anorexia, and weight loss (10 kg over same time period). Abdominal CT revealed a large (13X11 cm) heterogeneous cystic lesion occupying most of the pancreatic body. EUS examination confirmed the presence of a large mixed cystic-solid lesion occupying most of the pancreatic body and neck. EUS-guided FNA smears showed tumor cells in sheets with papillary/pseudo-papillary and acinar formation. The tumor cells had abundant clear and vacuolated cytoplasm and round to oval nuclei with bland chromatin. PAS staining revealed positively stained capillary networks at the core of the papillary/pseudo-papillary structures. In addition, there were PAS positive intra-cytoplasmic and extra-cellular globules which were diastase resistant. Immuno-cytochemical staining on direct smears revealed positive reaction for cyclinD1, vimentin, CD56, beta-catenin, CD10 and progesterone receptor. Thus, this is the example of an extremely rare neoplasm which had a typical clinical and imaging setting, and could be conclusively diagnosed because of characteristic cytomorphological and immunocytochemical features.

Solid Pseudopapillary Neoplasm of the Pancreas in a Pediatric Patient

Solid pseudopapillary neoplasm (SPN) is a rare epithelial neoplasm of the pancreas, with low malignant potential, that usually occurs in young women. With advancing diagnostic imaging techniques and technology, the number of documented SPN cases has increased. Due to a varying morphologic appearance, SPNs often fail to show typical imaging findings, making it difficult to establish a definitive diagnosis. A case is reported of a SPN discovered on a routine abdominal sonogram, further characterized with magnetic resonance imaging, and confirmed with surgical pathology analysis. Sonographers should be aware of this rare pathology and should consider SPN in the differential diagnosis when encountering an indeterminate pancreatic neoplasm, especially in a young female patient.

Pancreatic pseudopapillary tumour: A rare misdiagnosed entity

INTRODUCTION

Solid pseudo papillary pancreatic tumour is a rare entity. The atypical presentation causes a delayed or misdiagnosis of these pathology. It commonly affects the female population in the 2nd and 3rd decade of life. The presentation varies from non-specific abdominal pain to incidental findings in asymptomatic patients. It is a low-grade premalignant condition that is curable by excision of the tumour.

PRESENTATION OF CASE

This paper presents a 17-year-old girl with intra-abdominal mass diagnosed with solid pseudo papillary tumour that underwent Whipple's procedure.

DISCUSSION

We discuss the presentations, diagnosis and pathology findings of this rare pathology.

CONCLUSION

The diagnosis remains an enigma in view of the nature and location of the tumour. Resection is still the best choice remains for this condition.

Solid pseudopapillary tumour of pancreas

Solid pseudopapillary tumour of the pancreas is a rare neoplasm (1%). This tumour primarily affects young women and is usually treated with surgical resection with a relatively favourable prognosis. We report an 18-year-old female patient presenting with moderate grade abdominal pain for 5 weeks. Abdominal examination revealed a lump palpable in the right upper abdomen. Contrast-enhanced CT abdomen reported soft tissue lesion arising from uncinate process of pancreas causing adjacent compression. Endoscopic ultrasound-guided fine-needle aspiration biopsy yielded a cellular sample comprising pseudopapillary arrangement with bland appearing tumour cells consistent with benign neoplasm. And because of unusual location, Whipple procedure was performed. The patient was discharged under satisfactory conditions. Final histology confirmed the diagnosis. Solid pseudopapillary tumours of the pancreas are a rare but treatable pancreatic tumour. Complete surgical excision is the treatment of choice and can be achieved through an open or minimal access technique.

Solid pseudopapillary tumor: a rare neoplasm of the pancreas

Solid pseudopapillary tumor is a rare primary neoplasm of the pancreas that typically affects young women. It is a relatively a benign tumor, with a favorable prognosis. We here report a 27-year-old woman with solid pseudopapillary neoplasm, who presented with mild jaundice, mildly elevated liver function tests and right upper quadrant pain. Ultrasound was suggestive of hemorrhagic hepatic adenoma; however, on magnetic resonance imaging, a heterogenous mass was found in the head of pancreas. Endoscopic ultrasound-guided fine needle aspiration (FNA) revealed tumor cells with papillary architecture and immunohistochemical analysis showing cells positive for markers including beta-catenin, vimentin, alpha 1 antitrypsin etc. These findings were consistent with solid pseudopapillary neoplasm. The patient underwent pancreaticoduodenectomy. Post-surgical biopsy confirmed the FNA findings with tumor localized to the pancreas. The patient was not given any adjuvant therapy. She remained asymptomatic and showed no signs of disease after four months follow-up. It is important to differentiate this tumor from other pancreatic neoplasms, because this type is amenable to cure after complete surgical resection, even in cases with capsular invasion, unlike malignant tumors of the pancreas.