Solid pseudo-papillary tumors of the pancreas: current update

Abstract

Solid pseudo-papillary tumors are rare pancreatic tumors, which occur in females and are typically indolent neoplasms. However, atypical, aggressive variants can occur with locally advanced disease or metastases. They have characteristic imaging features, which vary according to size. This article provides a current update on the molecular biology, histopathology, clinico-radiological features, and management of these tumors.

Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiologic-pathologic correlation

“…differentiation (10). These tumors are also often texturally fairly soft; this accounts for the rarity of ductal dilatation and jaundice even for tumors arising in the pancreatic head (4,11). A fibrous pseudocapsule delineates the tumor from the rest of the pancreas, giving a well-circumscribed appearance on gross pathology (12,14).…”

“…Under the microscope, the tumor was composed of uniform epithelioid tumor cells, arranged in nests and pseudopapillary structures as viable tumor cells remained attached to hyalinized vascular cores (Fig. 4), while other cells further from the blood supply underwent degenerative changes (11)(12)(13)(14). It is due to this appearance that the tumor acquires its name.…”

“…A fibrous pseudocapsule delineates the tumor from the rest of the pancreas, giving a well-circumscribed appearance on gross pathology (12,14). Larger lesions tend to outgrow their blood supply (11) and undergo cystic degeneration and hemorrhage, which are seen as internal heterogeneity on CT (4,(11)(12)(13)(14). These gross pathologic features were reflected in our CT imaging findings (Fig.…”

Solid pseudopapillary tumor of the pancreas: Clinical features, diagnosis and treatment

“…Light microscopy defines the histopathological findings, which comprises solid areas alternating with pseudopapillary formation, cellular degeneration, including cholesterol clefts and aggregates of foaming histiocytes, uniform cells showing endocrine and exocrine characteristics, and clusters of cells arranged around a fibrovascular core. 4,16,17 More often, reported immunohistochemical aspects include positivity for progesterone receptors, vimentin, neuron-specific enolase (NSE) and α1-antitrypsin. 18 In our study, all cases tested were positive for progesterone receptors.…”

“…Its low malignant potential provides excellent long-term survival after surgical excision. 4,5 The present article describes clinical features and management of this uncommon pancreatic malignancy through a series of cases.…”