A case of middle-aged male with multicentric solid pseudopapillary neoplasm of the pancreas.

Abstract

Solid pseudopapillary neoplasm (SPN) of the pancreas is a low-grade, malignant pancreatic tumor that occurs predominantly in young females. In this report, an extremely rare case of multicentric SPNs in a middle-aged male is discussed. A 55-year-old man was incidentally found to have a mass in the pancreatic body on abdominal ultrasonography during a medical checkup. Contrast-enhanced computed tomography (CT) revealed masses with 50-mm and 25-mm diameters with internal calcification in the pancreatic body and tail, respectively. These masses had a gradually increasing enhancement pattern though the center of the pancreatic body mass and the periphery of the pancreatic tail lesion were non-enhancing. Magnetic resonance imaging revealed a hyperintense signal in the mass of the pancreatic tail suggestive of hemorrhage on T1-weighted imaging. Positron emission tomography-CT revealed abnormal uptake of fluorodeoxyglucose in both lesions. Endoscopic ultrasound-guided fine needle aspiration was performed on both lesions, and tumor tissue with a solid proliferation of poorly pleomorphic small cells was observed. The tumor cells were positive for CD10 in the cytoplasm and β-catenin in the nucleus. The patient was diagnosed with SPNs and underwent a successful distal pancreatectomy.