Attaallah Wafi, Javadov Mirhalig, Ayranci Fatma Gulcicek, Filinte Deniz, Dulundu Ender, Yegen Cumhur
Department of General Surgery, Marmara University School of Medicine. Istanbul, Turkey.
JOP. 2013 Jul 10;14(4):438-41. doi: 10.6092/1590-8577/1363.
Solid pseudopapillary tumor of the pancreas is a rare neoplasm, predominantly observed in young women and with greatest incidence in the second and third decade. Although large at the time of diagnosis, it has clinically good behavior. The occurrence of infiltrating varieties of solid pseudopapillary tumors is very rare.
We report the case of a 48-year-old man with a giant mass in the pancreas, incidentally discovered during an abdominal ultrasonography. The mass was later investigated using multidetector computed tomography and magnetic resonance imaging. The lobulated lesion had cystic-necrotic appearances which lead the radiologists to suggest the possibility of either a gastrointestinal stromal tumor or a pancreatic cancer. The patient was operated. Operative signs showed that the tumor invaded the splenic hilum and mesentery of transverse colon. En-block resection of pancreas, spleen and transverse colon was performed as the mass was thought to be a locally advanced pancreas tumor. Pathological diagnosis reported a solid pseudopapillary tumor.
Although solid pseudopapillary tumor is considered a rare tumor, with a very rare rate of locally infiltrating variety, and rarely presents in males, it must be kept in mind while making the differential diagnosis of cystic pancreatic lesions to begin appropriate clinical management.
胰腺实性假乳头状瘤是一种罕见的肿瘤,主要见于年轻女性,在第二和第三个十年发病率最高。虽然在诊断时体积较大,但临床行为良好。实性假乳头状瘤浸润性变种的发生非常罕见。
我们报告一例48岁男性,在腹部超声检查时偶然发现胰腺有巨大肿块。随后使用多排螺旋计算机断层扫描和磁共振成像对该肿块进行了检查。分叶状病变呈囊性坏死表现,这使得放射科医生怀疑可能是胃肠道间质瘤或胰腺癌。患者接受了手术。手术体征显示肿瘤侵犯了脾门和横结肠系膜。由于认为肿块是局部进展期胰腺肿瘤,遂行胰腺、脾脏和横结肠整块切除。病理诊断为实性假乳头状瘤。
虽然实性假乳头状瘤被认为是一种罕见肿瘤,局部浸润性变种的发生率极低,且很少见于男性,但在对胰腺囊性病变进行鉴别诊断时必须考虑到它,以便开始适当的临床处理。