Pancreatic neoplasm

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

5 thoughts on “Pancreatic neoplasm”

  1. Unfortunately I can not answer your question, however considering the rareness of this disease it may still help to corrospond. My 13 year old daughter was diagnosed with SPTP in August 2006. She has undergone 3 tumor remoal surgies with more to come to remove tumor in the liver. She has just began to have her menses two months ago and has not had one again yet.As you know this could be normal under any circumstances. I would be happy to put you in contact with her oncologist, or answer any questions.

  2. I am a medical student, kindly I need to know the relation between the Solid-pseudopapillary neoplasm and the production of oestrogen and progestrone, because there is a female patient born in January 6th 1982 who is recently had a pancreas resection in August 28th 2007 and post operatively the specimen was sent to the histopatholgy and the result was Solid-pseudopapillary neoplasm.
    Before the operation the doctors diagnosed the lesion of either Hydatid cyst or pseudopancreatric cyst but the patient was not convinced, she was keep telling the doctors about her gradual local distention in the left upper quadrant of the abdomen every time of her menses began. This story started with her since summer 1997; with every start of the bleeding she was feeling strange changes in her left upper quadrant, and every time of the bleeding the area becomes bigger and clearer palpated. After the result of the operation she believes that there is a strong and direct relation between this tumor and the oestrogen and progesterone.

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