Solid pseudopapillary Tumor of the Pancreas: Radiological and surgical review

Gandhi, Darshan; Sharma, Pranav; Parashar, Kalind; Kochar, Puneet; Ahuja, Kriti; Sawhney, Harpreet; Sharma, Salil

doi:10.1016/j.clinimag.2020.06.008

Cited by 28 publications

(29 citation statements)

References 26 publications

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“…The most typical CT finding of pancreatic adenocarcinoma is a solid hypoenhancing mass located in the distal body or tail of the pancreas associated with distal pancreatic atrophy and regional lymphadenopathy. In solid pancreatic pseudopapillary tumor, weak early arterial enhancement and gradual increase in the portal-venous phase was characteristic manifestation[ 20 ]. Local invasion to adjacent vasculature causing pseudoaneurysms may also be observed in many pancreatic adenocarcinoma cases[ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: A case report

Zhang¹,

Ma²,

Gao³

et al. 2021

WJCC

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BACKGROUND Metastases from pancreas or ampullary malignancies are common, but the spread to testicle and paratesticular tissue is exceedingly rare. To the best of our knowledge, fewer than 30 cases have been reported in the literature. More rarely, metastasis to tunica vaginalis testis occurs without involvement of the testes and epididymis. CASE SUMMARY A 65-year-old male who complained of painless swelling of the left scrotum for over 1 wk was referred to the Department of Urology. Scrotal ultrasound showed left testicular hydrocele with paratesticular masses. Chest computed tomography revealed lung metastasis and enlarged left supraclavicular lymph node.The blood tumor markersalpha-fetoprotein, human chorionic gonadotropin, and serum lactate dehydrogenase were withinnormal limits.The preoperative diagnosis was left testicular tumor with lung metastasis. Then radical orchidectomy of the left testicle and high ligation of the spermatic cord were performed, and postoperative histopathology suggested metastatic tumors that was confirmed by an abdominal computed tomographic scan. The positive computed tomography findings, in conjunction with the expression of cytokeratin 7 (CK7), CK20, CK5/6, and absence of expression of Wilms’ tumor suppressor gene 1, calretinin, melanocyte, prostate-specific antigen, thyroid transcription factor-1, GATA binding protein 3, caudal type homeobox 2, and napsinA supported the diagnosis of pancreatic adenocarcinoma. The outcome of this patient was unsatisfactory, and he died 3 mo later. CONCLUSION This case suggests that pancreatic metastatic carcinoma must be considered in the differential diagnosis of scrotal enlargement. The advanced age of the patient wassuggestive of a secondary testicular tumor.In addition, careful physical examination and ultrasonography as well as radiological examination have become a standard modality.

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Section: Discussionmentioning

confidence: 99%

Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: A case report

Zhang¹,

Ma²,

Gao³

et al. 2021

WJCC

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“…In general, they are the most useful studies, however, magnetic resonance imaging is very useful to identify chemical and solid tumors in the pancreas, in T1 areas of hemorrhagic degeneration can be determined as well as a hypointense capsule [ 1 , 3 ]. Positron emission tomography in general is not very useful since it is not possible to determine whether it is a benign or malignant neoplasm [ 4 , 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the case of our patient, based on the findings of the tomography, we decided to take the patient to surgery. It is difficult to make the decision to take a biopsy before surgery, especially in people of this age range due to the not so low risk of malignancy, as well as the possibility of dissemination, the best option for taking a biopsy by endoscopic ultrasound, without however, it remains controversial [ 4 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Frantz's tumor or solid pseudopapillary neoplasm is an extremely rare tumor with low malignant potential, it was first described by Dr. Virginia Kneeland Frantz in 1959 as a papillary cystic tumor of the pancreas in a 2-year-old child, in 1996 the WHO called them a solid pseudopapillary tumor, in 2010 it was reclassified as a solid pseudopapillary tumor of low grade of malignancy [ [1] , [2] , [3] , [4] ].…”

Section: Introductionmentioning

confidence: 99%

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Frantz tumor in a 58 year old woman; case report and literature review

Romero

Cárdenas

Vázquez

2021

Annals of Medicine &Amp; Surgery

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Introduction Frantz tumor or solid pseudopapillary neoplasm is a very rare tumor with low malignant potential, it constitutes 1–2 % of exocrine tumors of the pancreas. Description of the case We present the case of a 58-year-old female patient with a 4-month history of occasional abdominal pain in the epigastrium, the tomography detected a distal tumor of the pancreas. Is taken to distal pancreatectomy. Discussion It was first described by Franz in 1959 as a papillary tumor of the pancreas, in 2010 it was reclassified as a solid pseudopapillary tumor of low grade of malignancy. They appear in 8–16.6 % in patients before 13 years of age, in young women they present between the second and fourth decade of life. The treatment for excellence is surgical resection. Conclusion Pancreatic tumors represent a surgical challenge in any place of presentation.

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“…These types have unique paths during development and progression to invasive tumors[ 25 ], and specific genetic alterations observed in IPMNs may be responsible for tumor phenotypes and ultimately influence the patients’ outcome[ 26 , 27 ]. In most cases, other pancreatic lesions with cystic features, such as solid cystic neoplasm (SCN)[ 28 , 29 ], mucinous cystic neoplasm (MCN)[ 30 ], and solid pseudopapillary neoplasm (SPN)[ 28 ], can be easily distinguished from classic PDA[ 31 ]; however, atypical imaging findings of patients occasionally impair proper diagnosis. Knowledge and use of relevant genetic alterations unique to these cystic neoplasms may aid patients and physicians in making appropriate decisions.…”

Section: Introductionmentioning

confidence: 99%

Large-duct pattern invasive adenocarcinoma of the pancreas–a variant mimicking pancreatic cystic neoplasms: A minireview

Sato¹,

Liss²,

Mizukami³

2021

WJG

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Pancreatic cancer currently has no subtypes that inform clinical decisions; hence, there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteristics. Nonetheless, accumulating studies to date have revealed the large-duct type variant, a unique subtype of pancreatic ductal adenocarcinoma (PDA) with cystic features. This subtype often radiographically mimics intraductal papillary mucinous neoplasms (IPMNs) and involves multiple small cysts occasionally associated with solid masses. The “bunch-of-grapes” sign, an imaging characteristic of IPMNs, is absent in large-duct PDA. Large-duct PDA defines the mucin profile, and genetic alterations are useful in distinguishing large-duct PDA from IPMNs. Histologically, neoplastic ducts measure over 0.5 mm, forming large ductal elements. Similar to classic PDAs, this subtype is frequently accompanied by perineural invasion and abundant desmoplastic reactions, and KRAS mutations in codon 12 are nearly ubiquitous. Despite such morphological similarities with IPMNs, the prognosis of large-duct PDA is equivalent to that of classic PDA. Differential diagnosis is therefore essential.

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Solid pseudopapillary Tumor of the Pancreas: Radiological and surgical review

Cited by 28 publications

References 26 publications

Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: A case report

Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: A case report

Frantz tumor in a 58 year old woman; case report and literature review

Large-duct pattern invasive adenocarcinoma of the pancreas–a variant mimicking pancreatic cystic neoplasms: A minireview

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