Abstract
Solid-pseudopapillary tumor of pancreas is a rare neoplasm which occurs pre-dominantely in young females. This tumor generally is asymptomatic or minimally symptomatic and some imaging tests are useful for its diagnosis. We report a 17 years-old woman with dyspeptic symptoms submitted to an abdominal ultrasound (US), that revealed a hypoechogenic mass between the liver, right kidney and pancreas. Computer tomography (CT) scan showed a hypodense and heterogeneous mass on pancreas head. The patient underwent elective resection of the mass and the histopathology was consistent with a solid-pseudopapillary tumor of pancreas. Immunohistochemical positivity for NSE (neuron-specific enolase), progesterone receptor, alfa-1-antitrypsin, vimentin, AE1/AE3, and negativity for synaptophysin and chromogranin A confirmed the diagnosis. After four years of clinical follow-up, the patient remains in a good general condition without signs of tumor recurrence.
Highlights
Solid-pseudopapillary tumor of pancreas is a rare neoplasm which occurs predominantely in young females
Histogenesis remains a debatable question: acinar, endocrine, ductal and progenitor cells have been postulated as possible beginnings of this tumor[12]
Solid-pseudopapillary tumor of pancreas can be visualized in many imaging modalities, such as ultrasonography (US), X-ray computed tomography (CT) and magnetic resonance imaging, which can be used to differentiate it from other pancreatic lesions[1,2,4,15,16,17,18]
Summary
A 17-year-old girl complaining of dyspeptic symptoms and right upper quadrant pain for several months was admitted to our ambulatory for further evaluation. She had no history of abdominal trauma, surgery, drug usage or smoking. An abdominopelvic US revealed a heterogeneous hypoechogenic solid mass lesion measuring 10.1 x 9.1 x 9.0 cm at the underlying hepatic border, right kidney and head of pancreas. CT scan showed a round shaped well-marginated, hypodense and heterogeneous mass at the pancreatic head. After intravenous iodine contrast agent administration, the lesion showed minimally heterogeneous contrast enhancement markedly less than the normal pancreatic tissue (measuring 9 x 8 cm) (Figure 1A).The patient underwent elective resection of the abdominal mass (Figures 2A and 2B). The patient developed well in the postoperative period, with normal US (three, 12 and 24 and 48 months) and CT scans (12, 24 and 48 months) and no evidence of residual disease (Figure 1B)
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