Solid pseudopapillary tumor of pancreas: A case report

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Pancreatic Cancer
Presenter Sumanth Kumar
Authors S.M. Kumar1, G. Ushashree1, N. Rao2, R. Reddy3
  • 1Clinical Oncology, IRCS Cancer Hospital, 524004 - Nellore/IN
  • 2Surgical Oncology, IRCS Cancer Hospital , 524004 - Nellore/IN
  • 3Pathology, IRCS Cancer Hospital, 524004 - Nellore/IN

Abstract

Case Summary

Solid pseudopapillary neoplasm of pancreas (SPN) is a rare entity. It is almost exclusively seen in females and occurs in the second or third decades of life. Due to the paucity of the number of cases seen, the natural history of the disease is not fully understood. There has been a steady increase in the number of diagnosed cases of SPN in the last 10 years. Here, we present you a case of SPN from our institution. A 35-year-old female presented with C/O lump per abdomen-2 months with no other complaints and no co-morbidities. O/E: ECOG-1, General Exmination -grossly normal. P/A- Ill defined large abdominal mass 7*8 cm occupying epigastrium and left hypochondrium. CECT abd: Well encapsulated heterogenously enhancing solid mass arising from tail of pancreas with no adjacent organ invasion. Liver- Normal. Slpeen enlarged. No abdominal lymphadenopathy. CA19.9- 0.56 U/ml. Pt underwent distal pancreatectomy + splenectomy along with excision of mass. HPE & IHC: Solid Pseudopapillary neoplasm of pancreas. 0/14 LN's free of tumor. Margins- free. Spleen- Congestive Splenomegaly. Capsule is intact with tumor invasion into capsule +. - Patient was kept on close follow up for 6 months post op with no evidence of recurrence. Discussion: SPN is predominantly encountered in young, female patients (first 3 decades of life), but has also been reported in males and in children Depending on the tumour position (head, body or tail), the differential diagnosis includes adrenal mass, pancreatic endocrine tumour, liver cyst or tumour, or a pseudocyst. The histogenesis of these tumours is unknown but they possibly originate from the primordial cells and lack definite endocrine and exocrine differentiation. SPN is considered to be a tumour of low-grade malignant potential. Complete surgical excision is the best option even if it implies that major resections (like pancreaticoduodenectomy along with adjacent organ resection) have to be performed. Patients with SPN have an excellent prognosis after surgical excision. A local recurrence rate of 6.2% is reported in cases treated by radical surgical excision, and hepatic or Krukenberg-type distant metastases develop in 5.6% of cases (Gonzalez-Campora R et al.).

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