Distal Pancreatectomy for Solid Pseudopapillary Tumor of the Pancreas: A Case Report.

Narcisa Guimaraes,Raquel Oliveira Dias,Carlos Vila Nova,José Valente Cecílio,Joao Fonseca Pinho

doi:10.7759/cureus.19880

Abstract

Solid pseudopapillary tumor (SPT) of the pancreas is a rare tumor, sometimes asymptomatic, mainly affecting young females. It has a low malignant potential, and its complete surgical resection with free margins is the treatment of choice, offering an excellent prognosis. We present the case of a 43-year-old healthy female who was referred to the surgery department for a large abdominal mass found in the abdominal ultrasound. In the course of the study of this mass, an abdominal CT with fine needle aspiration (FNA) was performed, revealing a solid pseudopapillary tumor of the tail of the pancreas. A laparotomic distal pancreatectomy with total splenectomy was performed. A grade B pancreatic fistula occurred on the third postoperative day, and she was released on postoperative day 11. Histopathology study revealed a 10 cm solid pseudopapillary tumor of the pancreas, with cavities filled with hematic content and limited by a partially calcified capsule. SPT is a rare and indolent tumor. Prognosis is highly favorable after an adequate surgical resection, hence the importance of a precise preoperative diagnosis. Therefore, it is important to choose the most appropriate surgical strategy for each patient.

Highlights

First described in 1959 by Virginia Frantz as papillary cystic tumors of the pancreas, solid pseudopapillary tumors (SPT) of the pancreas had several different names, acquiring their current classification since the revision of the WHO classification in 1996 [1,2]
Located more frequently on the tail or body of the pancreas, it affects mostly women at a young age [4,5]. It usually presents a slow growth, with low malignant potential, and is asymptomatic in a significant percentage of cases [2], until it is detected in routine examinations
Treatment consists of complete resection of the tumor lesion with free margins, which can be curative [6]

Summary

Introduction

First described in 1959 by Virginia Frantz as papillary cystic tumors of the pancreas, solid pseudopapillary tumors (SPT) of the pancreas had several different names, acquiring their current classification since the revision of the WHO classification in 1996 [1,2] It is a rare pancreatic tumor, accounting for 1%-2% of all tumors that affect this organ [2,3]. A 43-year-old female with no comorbidities was referred to general surgery in-hospital consultation by her assistant physician for a “pancreatic mass, predominantly solid, heterogeneous, located in the tail of the pancreas, measuring 9 × 8 cm.”. The patient remains asymptomatic and without signs of recurrence eight years after the surgical procedure

Discussion

Conclusions

Findings

Disclosures