Solid pseudopapillary neoplasm of the pancreas: a case report

Abstract

This paper presents a case report of a solid pseudopapillary neoplasm (SPN) of the pancreas, a discussion on the clinical-pathological, histopathological, and immunohistochemical picture, and a review of the literature regarding the occurrence of this type of cancer. The case of a 61-year-old woman with the presence of a lithium-cystic lesion of the body and tail of the pancreas was initially assessed by MRI as a pathological mass with the presence of abscesses. Double biopsy under EUS control was non-diagnostic. The patient underwent surgery to remove the body and tail of the pancreas together with the tumour and spleen. Tumour size 15×10×8 cm lithium-cystic, grey-brown, with the presence of numerous calcifications and bone metaplasia, and stones in the pancreatic duct. In the histopathological picture, solid woven with the presence of pseudodimplants and pseudocystic areas with haemorrhages. Positive tests for NSE, vimentin, PR, CD56, and cyclin D1 were obtained in immunohistochemical (IHC) tests. The patient was discharged from the hospital in good general condition and is under gastroenterological control. SPN is a rare cancer with low malignancy. The tumour most often occurs in teenagers or young women. Initially, it runs without ailments, until it is large. Then there is pain, nausea, and fever. The histopathological and cytological picture is suggestive, but it should be supported by research. SPN should be differentiated with neuroendocrine tumours (NENs) and acinar cancer and pancreatoblasoma. SPN generally has a good prognosis. Local relapses and distant metastases are rare.