A solid pseudopapillary tumour of the pancreas
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CASE REPORT
A Solid Pseudopapillary Tumour of the Pancreas O. Baraket, M. Moussa, K. Ayed, S. Ben Hmida, B. Kort, I. Cheikh, S. Bouchoucha
Abstract Solid pseudopapillary tumour of the pancreas is a rare neoplasm which, for the most part, affects young women and has a relatively favourable prognosis with low malignant potential. We report the case of a 48-year-old woman with a pseudopapillary tumour of the pancreas. Abdominal computed tomography and magnetic resonance imaging showed a solid, cystic mass in the pancreas. She was successfully treated with a cephalic duodenopancreatectomy. The SPT is an infrequent tumour, typically affecting young women. Surgical resection is generally curative, even in locally advanced or metastatic disease Keys words: Solid-pseudopapillary tumour; diagnosis, treatment; surgery
Introduction Solid pseudopapillary tumour (SPT) of the pancreas, first reported by Frantz in 1959 [1], is a rare neoplasm, accounting for less than 2% of exocrine pancreatic neoplasms [2,3]. The number of reported cases is rapidly increasing owing to the widespread use of imaging techniques and a better knowledge of the disease. A recent review of the English literature from 1933 to 2003 identified a total of 718 SPTs, including paediatric cases [2]. This tumour primarily affects young women and is usually treated with surgical resection [3]. On the whole, prognosis is relatively favourable after resection and follow-up.
Case report Written informed consent was obtained from the patient for publication of her medical data. A 49-year-old woman was admitted to our institution for recurrent abdominal pain. She had been treated for pulmonary tuberculosis for four months. Physical examination revealed mild epigastric tenderness and a non-palpable mass. Routine laboratory test results, including tumour marker levels (carcinoembryogenic antigen, alpha-fetoprotein, CA 19-9) were within normal limits. Abdominal ultrasonography demonstrated an epigastric heterogeneous semi-solid mass with cystic components. Computed tomography (CT) showed a solid, cystic mass measuring 11 cm in diameter,
O. Baraket, M. Moussa, K. Ayed, S. Bouchoucha Department of Surgery, Bizerte Hospital, Tunisia S. Ben Hmida, B. Kort, I. Cheikh Department of Gastroenterology, Bizerte Hospital, Tunisia Corresponding author: Baraket Oussama E-mail: [email protected] Received 18 Nov 2013; Accepted 31 June 2014 Hellenic Journal of Surgery 86
involving the head of the pancreas. Abdominal magnetic resonance imaging (MRI) identified a solid, cystic mass in the pancreas without involvement of the portal and superior mesenteric vein. Exploratory laparotomy revealed an encapsulated mass measuring 5 cm in diameter located in the pancreatic head. There was no sign of invasion of the superior mesenteric artery and vein or any evidence of hepatic metastasis. The patient underwent a cephalic duodenopancreatectomy. Her postoperative course was uneventful. Histologic examination found small, uniform cells with eosinophilic granular cytoplasm, along with typical
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