Rivera Melisa, Lara-Del Rio Jose A, Di Pasquale-Guadalupe Lorena, Zequeira Jorge
Department of Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Department of Pathology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Am J Case Rep. 2017 Jun 12;18:656-659. doi: 10.12659/ajcr.902867.
BACKGROUND Solid pseudopapillary neoplasm (SPN) is a rare tumor frequently found in the head or tail of the pancreas. It mainly presents in young women between the 2nd and 3rd decades of life. A predilection for African Americans and Asians has been observed and is rarely reported in children. Most patients are symptomatic, with abdominal pain as the most common presenting symptom. Clinical laboratory test results are usually normal and pancreatic markers are not typically elevated. Metastatic disease is very uncommon, but most often metastasizes to the liver and regional lymph nodes. Prognosis is usually excellent after surgical resection. CASE REPORT We present the case of a 14-year-old Hispanic female who presented to the emergency department after a high-speed motor vehicle accident. She suffered multiple body traumas. Specifically, the patient referred severe epigastric pain. No significant past medical or surgical history was obtained. Laboratory workup was non-contributory. Further evaluation with abdomen and pelvis contrast-enhanced computed tomography and magnetic resonance imaging revealed a pancreatic tail mass. Distal pancreatectomy followed. Pathologic diagnosis of SPN was established. CONCLUSIONS SPN is a rare exocrine tumor with excellent prognosis following resection. Imaging findings are suggestive, but a pathology evaluation is necessary to make the final diagnosis. Differential diagnosis includes entities such as mucinous cystic pancreatic tumor, pancreatic ductal carcinoma, and pancreatic serous cystadenoma. Radiologists play a vital role in the diagnosis, since many times, as in our case, it presents as an incidental finding. A small percentage of SPN neoplasms are associated with metastasis or local recurrence. Therefore, the aim of our case presentation is to review key imaging findings to guide early management and surgical planning.
实性假乳头状瘤（SPN）是一种罕见肿瘤，常见于胰腺头部或尾部。它主要发生于20至30岁的年轻女性。已观察到非洲裔美国人和亚洲人对此肿瘤有偏好，儿童中罕见报道。大多数患者有症状，腹痛是最常见的症状。临床实验室检查结果通常正常，胰腺标志物通常不升高。转移性疾病非常罕见，但最常转移至肝脏和区域淋巴结。手术切除后预后通常良好。病例报告：我们报告一例14岁西班牙裔女性，在高速机动车事故后就诊于急诊科。她遭受多处身体创伤。具体而言，患者自述上腹部剧痛。未获得显著的既往病史或手术史。实验室检查无诊断意义。通过腹部和盆腔增强计算机断层扫描及磁共振成像进一步评估发现胰腺尾部肿块。随后进行了胰体尾切除术。确立了SPN的病理诊断。结论：SPN是一种罕见的外分泌肿瘤，切除后预后良好。影像学表现有提示作用，但最终诊断需要病理评估。鉴别诊断包括黏液性囊性胰腺肿瘤、胰腺导管癌和胰腺浆液性囊腺瘤等实体。放射科医生在诊断中起至关重要的作用，因为很多时候，如我们的病例，它是偶然发现的。一小部分SPN肿瘤与转移或局部复发有关。因此，我们病例报告的目的是回顾关键影像学表现以指导早期管理和手术规划。
