Solid Pseudo Papillary Neoplasm of the Pancreas- Rare and Clinically Unexpected: Case Report with Review of Literature
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 7
Abstract
Solid pseudo papillary tumor (SPN) is a unusual primary neoplasm of the pancreas that customarily affects young women. SPN accounts for less than 1% to 2% of exocrine pancreatic tumors. Most common presenting symptom is abdominal mass sometimes associated with dyspepsia, decreased appetite, and weight loss. Vomiting and nausea occur in few patients but they are less common presenting symptoms. Most patients present with indefinite, non-specific abdominal pain which results in delayed diagnosis. Asymptomatic tumors are seen in up to 25 % of cases and they are incidentally detected on imaging or at operation for some other unrelated pathological condition. Pancreatic SPNs are usually indolent tumors. The exact cell of origin is still disputed. Grossly, size of the tumor may range from 3.0 cm to more than 10 cm in diameter. The microscopic features show alternate variable solid areas with cystic component and pseudo papillary formations. Cells are usually polygonal with bland oval to round nuclei and eosinophilic cytoplasm. Various synonyms were used by various authors around the world, According to the author Kloppel G et al.; some of the synonyms used to describe SPPN are 1) solid cystic tumor 2) papillary cystic tumor 3) papillary epithelial neoplasia 4) solid and papillary epithelial neoplasia 5) papillary epithelial tumor 6) Frantz’s tumor 7) solid and papillary tumor 8) solid-cystic papillary epithelial neoplasm 9) benign or malignant papillary tumor of the pancreas. In the year 1996, World Health Organization (WHO) came up with the single nomenclature as Solid Pseudo Papillary Neoplasm (SPN). We present a rare case of SPN in a 40 year old female patient who presented to the hospital with complaints of abdominal pain, loss of appetite and fever. Clinically and radiologically diagnosis of pancreatic pseudo cyst was made. Histopathological examination (HPE) gave the definitive diagnosis and proved to be a valuable investigation in this case. Keywords: Solid Pseudo papillary tumor (SPN), Solid Pseudo papillary Neoplasia, Pseudo cyst of pancreas, Prognosis, IHC, Vimentin, Alpha Antitrypsin, Ki-67.
Authors and Affiliations
Dr. Vanita Pandey, Dr. V. Indira, Dr. K. Mahesh Kumar
Keywords
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