Yasuda Hiroaki, Kataoka Keisho, Miyake Hayato, Sogame Yoshio, Sakagami Junichi, Yasukawa Satoru, Konishi Eiichi, Yanagisawa Akio, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.
Clin J Gastroenterol. 2023 Feb;16(1):105-109. doi: 10.1007/s12328-022-01715-4. Epub 2022 Oct 10.
A solid pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm that mainly occurs in young women. We herein report the case of spontaneous regression in SPN of the pancreas. A 48-years-old female was found to have a mass in the head of the pancreas on examination for her back pain and referred to our hospital in 20XX. Laboratory data showed no abnormalities in serum levels of pancreatic enzymes and tumor markers. A contrast CT scan of upper abdomen showed a slightly enhanced lesion (23 × 19 mm in diameter) without cystic component or fibrous capsule in the head of the pancreas. An MRI scan showed the mass as low-intensity in T1-WI and high-intensity in T2-WI. She admitted to our hospital for further examination of a pancreatic mass by EUS-FNA in 20XX + 4. EUS showed a slightly hypoechoic mass (30 × 19 mm in diameter) compared with the neighboring normal pancreas. Tumor margin was relatively clear and the internal echo image was homogenous. Histological findings revealed a solid and pseudopapillary proliferation of eosinophilic polygonal cells with oval nuclei. The tumor cells were positive for vimentin and CD10 in the cytoplasm and β-catenin in the nuclei, which led to the diagnosis of SPN. We recommended this patient to undergo surgical resection, however, the patient chose follow-up examinations. Follow-up study after 1 year using MRI scan showed spontaneous regression, which was coincided with her menopause. These findings suggest that the natural regression of SPN may occur and female sex hormone changes may regulate the growth of SPN.
胰腺实性假乳头状瘤（SPN）是一种罕见肿瘤，主要发生于年轻女性。我们在此报告一例胰腺SPN自发消退的病例。一名48岁女性因背痛检查时发现胰腺头部有一肿块，于20XX年转诊至我院。实验室检查显示血清胰酶和肿瘤标志物水平无异常。上腹部增强CT扫描显示胰腺头部有一稍强化病灶（直径23×19mm），无囊性成分或纤维包膜。MRI扫描显示该肿块在T1加权像上呈低信号，在T2加权像上呈高信号。20XX + 4年她因胰腺肿块进一步检查入住我院行EUS - FNA。EUS显示与邻近正常胰腺相比，有一稍低回声肿块（直径30×19mm）。肿瘤边界相对清晰，内部回声均匀。组织学检查发现嗜酸性多边形细胞呈实性和假乳头状增生，细胞核呈椭圆形。肿瘤细胞胞质中波形蛋白和CD10阳性，细胞核中β - 连环蛋白阳性，据此诊断为SPN。我们建议该患者行手术切除，但患者选择了随访检查。1年后MRI扫描随访研究显示自发消退，这与她绝经时间相符。这些发现提示SPN可能会自然消退，女性性激素变化可能调节SPN的生长。
