A previously healthy 27 years old female came to the emergency department with a chief complaint of one-month diffuse and intermitent abdominal pain, transitory relief with bowel movements, nausea without vomit, early saciety, postprandial fullness and weight loss of 4 kilos in 1 month.
On the physical exam, we found a 10×15 cm tumor in the left upper quadrant. The tumor is not fixed, it feels solid and well delimited. We did not find any other important data.
Lab work beteween normal ranges. We ordered plain abdominal film, chest x ray and later an abdominal ultrasound and a CT scan.
Rx
Ultrasound
CT Scan
With these findings, we decided to perform an exploratory laparotomy (left subcostal incision) and tumor resection.
Look the size of the tumor and its characteristics.
Note the splenic vein.
The tumor arises from the tail of the pancreas. It was impossible to dissect the spleen, so we had to cut it.
Pathology
Final diagnosis: Benign Solid Pseudopapillary Tumor of the Pancreas of 14 cm, and 1.66Kg.
Solid-pseudopapillary tumor (SPT) of pancreas is a very rare (about 450 cases have been described in the world literature) neoplasm of low malignant potential and unknown origin. It generally occurs in young women and the prognosis is usually good after complete surgical removal.
SPT is also know as Fratz’s tumor
