Solid Pseudopapillary Tumor of the Pancreas: a Case Report

Solid pseudopapillary tumors (SPT) of the pancreas are considered to be a rare low-grade malignancy that mainly appears in young women. It accounts for less than 1% of all pancreatic neoplasms and is pathologically distinctive from other types of pancreatic cancers. Curative resection is the optimal choice for SPT and the 5-year survival rate of SPT is about 95%. Here we report a case of a young girl who presented with this rare pancreatic tumor. This case involved a 21-year-old girl with a 3-month history of a slowly growing palpable mass in the right upper abdomen.There were no accompaning symptoms, except for a 5-kilogram weight loss since the onset of the disease. Her past medical history as well as that of her family was unremarkable. Physical examination showed a distinct mass in the right upper quadrant which showed no tenderness.The routine test of blood and the serum tumor markers, such as CEA and CA19-9, were within normal levels. An abdomenal CT scan revealed a well-encapsulated, 6.9×9.3 cm2 mass in the right retro-peritoneal area with a cystic lesion inside. The pancreatic head, duodenum and the right kidney were pushed aside, but there was no sign of invasion into the surrounding organs and the important vessels (Fig.1). The patient underwent a laparotomy after sufficient preparation. Intraoperatively, a large, wellencapsulated mass was detected in the posterior surface of the pancreatic head with no invasion of the surrounding area. A tumor resection was performed (Fig.2), and her recovery was routine so she was discharged 19 days after surgery. Post-operative pathologic examination revealed a 9×9×7 cm3 nodi-formed mass mixed with zones of hemorrhage.The cells were small and uniform with nuclei that were ovoid with nuclear grooves and with inconspicuous nucleoli (Fig.3). Immunohistochemical results showed that the cells were negative for cytokeratin, S100, synaptophysin, and chromogranin stains and positive for vimentin, CD10, neuron-specific enolase (NSE) and CD56. The immunohistochemical results supported the diagnosis of a solid pseudopapillary tumor of the pancreas.