Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Clin J Gastroenterol. 2023 Jun;16(3):488-494. doi: 10.1007/s12328-023-01785-y. Epub 2023 Mar 23.
Solid pseudopapillary neoplasm (SPN) of the pancreas is a low-grade, malignant pancreatic tumor that occurs predominantly in young females. In this report, an extremely rare case of multicentric SPNs in a middle-aged male is discussed. A 55-year-old man was incidentally found to have a mass in the pancreatic body on abdominal ultrasonography during a medical checkup. Contrast-enhanced computed tomography (CT) revealed masses with 50-mm and 25-mm diameters with internal calcification in the pancreatic body and tail, respectively. These masses had a gradually increasing enhancement pattern though the center of the pancreatic body mass and the periphery of the pancreatic tail lesion were non-enhancing. Magnetic resonance imaging revealed a hyperintense signal in the mass of the pancreatic tail suggestive of hemorrhage on T1-weighted imaging. Positron emission tomography-CT revealed abnormal uptake of fluorodeoxyglucose in both lesions. Endoscopic ultrasound-guided fine needle aspiration was performed on both lesions, and tumor tissue with a solid proliferation of poorly pleomorphic small cells was observed. The tumor cells were positive for CD10 in the cytoplasm and β-catenin in the nucleus. The patient was diagnosed with SPNs and underwent a successful distal pancreatectomy.
胰腺实性假乳头状瘤（SPN）是一种低级别、恶性的胰腺肿瘤，主要发生在年轻女性中。本报告讨论了一例非常罕见的中年男性胰腺多中心 SPN 病例。一名 55 岁男性在体检时行腹部超声检查偶然发现胰体部有一肿块。增强 CT 显示胰体部和胰尾部分别有 50mm 和 25mm 直径的肿块，内有钙化。这些肿块的增强模式逐渐增加，尽管胰体部肿块的中心和胰尾部病变的外围没有增强。磁共振成像显示胰尾部肿块 T1 加权成像上呈高信号，提示出血。正电子发射断层扫描-CT 显示两个病变均有氟脱氧葡萄糖的异常摄取。对两个病变均行超声内镜引导下细针抽吸，观察到肿瘤组织呈实性增殖，细胞形态较差，呈小圆形。肿瘤细胞胞质中 CD10 阳性，核内 β-连环蛋白阳性。患者被诊断为 SPN，并成功进行了胰远端切除术。
