Multicentric solid pseudopapillary neoplasms of the pancreas diagnosed by endoscopic ultrasound-guided fine needle aspiration: a case report.

Megumi Yamaguchi,Toshio Noriyuki,Daisuke Takei,Yusuke Sumi,Toshikatsu Fukuda,Masumi Kawashima,Hironobu Amano,Masahiro Nakahara,Mio Amano,Shuji Yonehara,Keiji Hanada

doi:10.1186/s40792-015-0111-8

Megumi Yamaguchi, Toshio Noriyuki + Show 9 more

Open Access

https://doi.org/10.1186/s40792-015-0111-8

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Abstract

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor. This neoplasm usually arises as a single mass; multicentricity is exceptionally rare. We report the preoperative diagnosis of multicentric SPNs by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). A 32-year-old woman presented to the hospital with a pancreatic tumor that was detected on abdominal echography. Contrast-enhanced computed tomography (CT) scans revealed a 5-mm low-density mass in the body of the pancreas and a 10-mm mass in the tail of the pancreas. Magnetic resonance imaging (MRI) also revealed two tumors in the body and tail of the pancreas. On endoscopic ultrasonography (EUS), two indistinct and heterogeneous echogenic masses were found, and EUS-FNA was performed for each of these tumors. Cytological analysis revealed that the two masses were highly cellular with papillary groups of small, uniform, oval cells surrounding a fibrovascular core. Immunohistochemistry was positive for α-1 antitrypsin, vimentin, neuron-specific enolase (NSE), CD10, and progesterone receptor. These features confirmed the preoperative diagnosis of multicentric SPNs. The patient underwent laparoscopic distal pancreatectomy with splenectomy. The final pathologic diagnosis was multicentric SPNs. During 2 years of follow-up, she has not developed any recurrence.

Highlights

Solid pseudopapillary neoplasm (SPN) of the pancreas is rare, accounting for approximately 0.13–2.7 % of all pancreatic tumors and 1–2 % of all exocrine pancreatic tumors [1]
* Correspondence: megumi.yamaguchi0715@gmail.com 1Department of Surgery, Onomichi General Hospital, 1-10-23, Hirahara, Onomichi, Hiroshima 722-8508, Japan Full list of author information is available at the end of the article diagnosis of multicentric SPNs by endoscopic ultrasoundguided fine needle aspiration (EUS-FNA)
Song et al found that the cytological features of SPN, as assessed by endoscopic ultrasonography (EUS)-FNA, are highly characteristic and distinct from those of other cystic or solid pancreatic tumors [11]

Summary

Introduction

Solid pseudopapillary neoplasm (SPN) of the pancreas is rare, accounting for approximately 0.13–2.7 % of all pancreatic tumors and 1–2 % of all exocrine pancreatic tumors [1]. Background Solid pseudopapillary neoplasm (SPN) of the pancreas is rare, accounting for approximately 0.13–2.7 % of all pancreatic tumors and 1–2 % of all exocrine pancreatic tumors [1]. * Correspondence: megumi.yamaguchi0715@gmail.com 1Department of Surgery, Onomichi General Hospital, 1-10-23, Hirahara, Onomichi, Hiroshima 722-8508, Japan Full list of author information is available at the end of the article diagnosis of multicentric SPNs by endoscopic ultrasoundguided fine needle aspiration (EUS-FNA). Case presentation A 32-year-old woman presented to our hospital with a pancreatic body tumor, which was identified by abdominal echography during health screening.

Results

Conclusion