Malignant solid pseudopapillary tumor of pancreas causing sinistral portal hypertension

Abstract

Solid pseudopapillary tumor (SPT) of the pancreas is a rare benign or low-grade malignant epithelial tumor that occurs mainly in young females in second to fourth decades of life. Pathologic and imaging findings include a well-defined, encapsulated pancreatic mass with cystic and solid components with evidence of hemorrhage. We report a 23-year-old female who presented with upper abdominal pain of long duration and epigastric mass on palpation. Multidetector-row CT (MDCT) demonstrated a large well-defined heterogeneous attenuation mass, containing hyperdense areas of hemorrhage mixed with solid enhancing and cystic non-enhancing areas, arising from the pancreatic body and tail. Splenic vein thrombosis was present with dilated splenoportal collateral vessels between splenic hilum and portal/superior mesenteric veins, with dilated vessels seen in the gastric wall, with patent portal vein, compatible with sinistral portal hypertension. Typical imaging features and age and sex of the patient suggested a diagnosis of SPT of pancreas complicated by segmental portal hypertension due to splenic vein thrombosis. Histopathology of the biopsy material was confirmatory.

Solid pseudo-papillary tumor of pancreas: A rare case report and review of Indian literature

“…Although there has been a steady increase in the number of diagnosed SPT cases globally, in India, only seven case reports describing 26 cases of SPTs are published [ Table 1]. [3,[5][6][7][8][9][10] All the cases reported were females, aged between 13 and 50 years. Pain in abdomen and painless abdominal lump were the commonest presenting symptoms.…”

Solid Pseudopapillary Neoplasm of the Pancreas Clinicopathological Characteristics and Long-Term Outcome: a Single-Center Experience

“…Kamat et al reported a case of SPT followed for 3 years without significant change in size of the tumor [11]. Rarely, SPTs can present with splenic vein thrombosis with sinistral portal hypertension [12]. No laboratory values are contributory and some cases can have elevated Ca 19-9 levels [6].…”

A rare case report of Solid Pseudopapillary Tumor of the pancreas with portal hypertension

“…However, not many case reports have been documented where surgery has been performed on cases with sinistral portal hypertension. One case report by Wani et al describes a case of malignant SPT treated by exploratory laparotomy and excision with splenectomy [4] . Ours is the first report on a benign SPT with sinistral hypertension treated with distal pancreatectomy.…”