Solid Pseudopapillary Tumor of Pancreas in a 15-year-old Female: A Case Report

Abstract

Solid pseudopapillary tumor (SPT) is a very rare tumor accounting for only 1% of all pancreatic exocrine tumors. In this case, patient is a 15-year-old female with history of obesity and oligomenorrhea. She was admitted with a six-day history of severe upper abdominal pain, non-bloody vomiting and occasional diarrhea with no history of fever or sick contact. MRI abdominal examination with contrast showed a cystic 3.4 x 2.2 x 2.0 cm mass in the tail of the pancreas. Patient then underwent the distal pancreatectomy and splenectomy. Grossly, the tumor mass is well-circumscribed and has a tan/yellow cystic cut surface. Microscopically, most of the tumor tissue is necrotic.  Sheets of cells demonstrate pseudopapillary arrangement in the preserved area.  The nuclei are uniform without apparent mitotic figures and cytoplasm is moderate and eosinophilic. Immunohistochemistry study revealed that tumor cells are positive for CD10, progesterone receptor, synaptophysin and nuclear beta-catenin staining. Diagnosis of this case is challenging because extensive necrosis of the tumor tissue, however, the small areas of residual tumor still retain the pseudopapillary architecture and nested pattern. Individual tumor cells have monotonous low grade character. Immunoprofile also supports the diagnosis of solid pseudopapillary tumor.

[N A J Med Sci. 2019;12(1):021-023.   DOI:  10.7156/najms.2019.1201021]