Small solid pseudopapillary tumor of the pancreas in a 32-year-old man: report of a case

Surg Today. 2010 Aug;40(8):772-6. doi: 10.1007/s00595-009-4139-x. Epub 2010 Jul 30.

Abstract

A solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm that mainly occurs in young women. We herein report the case of a small SPT arising from the head of the pancreas in an asymptomatic 32-year-old man, plus a literature review of this tumor. A 32-year-old man was admitted to our department at Kumamoto University Hospital for the evaluation of a pancreatic mass. The tumor had central necrosis, which was poorly perfused on contrast-enhanced computed tomography (CT) and which had a high intensity on T2-weighted magnetic resonance imaging (MRI). Histology revealed the lesion to be a solid pseudopapillary tumor of the pancreas, with the characteristic pseudopapilla formation and central degeneration. However, no capsule formation was observed. The tumor was positive for CD56, CD10, alpha1-antitrypsin, alpha1-antichymotrypsin, beta-catenin, and progesterone receptor. However, the tumor was negative for pancreatic hormones, chromogranin-A, carcinoembryonic antigen, and carbohydrate antigen 19-9. We diagnosed the patient to have an SPT based on these histological findings. Small-sized solid pseudopapillary tumors of the pancreas are being increasingly recognized because of the recent advances in CT and MRI. We should also consider SPT even if it occurs in a male when the tumor contains necrosis-suspected areas which are poorly perfused on contrast-enhanced CT with a high intensity on T2-weighted MRI.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • CD56 Antigen
  • Carcinoma, Papillary / diagnosis*
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / surgery
  • Humans
  • Lymph Node Excision
  • Magnetic Resonance Imaging
  • Male
  • Neprilysin
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy
  • Prognosis
  • Receptors, Progesterone
  • Tomography, X-Ray Computed
  • alpha 1-Antichymotrypsin
  • alpha 1-Antitrypsin
  • beta Catenin

Substances

  • CD56 Antigen
  • Receptors, Progesterone
  • alpha 1-Antichymotrypsin
  • alpha 1-Antitrypsin
  • beta Catenin
  • Neprilysin