Management of a Pregnancy with a Solid Pseudopapillary Neoplasm of the Pancreas

Abstract

A 26-year-old primigravid patient, at 35 weeks and 2 days of gestation, was referred to Hacettepe University Hospital for pancreatic mass, giant cervical myoma, maternal systemic lupus erythematosus, thrombocytopenia, and onset of preterm labor. At 36 weeks and 1 day of gestation (6 days after admission to the hospital), regular uterine contractions started and cervical dilatation with effacement was observed. Because of breech presentation and giant cervical myoma, a cesarean section was performed on the primigravid patient under general anesthesia. Four months after the birth, subtotal pancreatectomy, partial gastrectomy, duodenectomy, cholecystectomy, and omentectomy (Whipple procedure) were performed. The pathologic diagnosis was of a solid pseudopapillary neoplasm of the pancreas; the patient was discharged from hospital after ten days.

Solid pseudopapillary tumour of the pancreas in pregnancy – a case report and literature review

“…However, local invasion and distant organ and lymph node metastases have been reported. [2,6] SPTs commonly occur in the pancreatic tail, although they have been reported in the head and body. [5] They present with nonspecific features/symptoms which makes diagnosis difficult.…”

“…[5] They present with nonspecific features/symptoms which makes diagnosis difficult. [3,6] Some symptoms are as a result of the tumour compressing the adjacent pancreas and include vomiting, nausea, and jaundice. Although the symptoms are nonspecific, abdominal discomfort/pain and a mass are the commonest features.…”

“…Although the symptoms are nonspecific, abdominal discomfort/pain and a mass are the commonest features. [6] The index patient presented with mild abdominal pain and a mass without other symptoms. The differential diagnosis for these signs and symptoms is vast and not diagnostic.…”

Pancreatitis During Pregnancy Revealing Solid Pseudopapillary Tumor of the Pancreas: Case Report

“…• Positivity for progesterone receptors is sometimes reported, which may explain female predominance [6].…”

“…• A long-term follow-up is required to detect any recurrence which occurs in about 10 to 15% and which needs surgical intervention [1,6,7].…”