Maity Rick, Dhali Arkadeep, Chattopadhyay Prajes Kumar, Biswas Jyotirmoy, Dhali Gopal Krishna
Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India; Sheffield Teaching Hospitals NHS Foundation Trust, UK; School of Medicine and Population Health, University of Sheffield; School of Medicine, University of Leeds, UK; Deanery of Clinical Sciences, The University of Edinburgh, UK.
Int J Surg Case Rep. 2025 Jan;126:110635. doi: 10.1016/j.ijscr.2024.110635. Epub 2024 Nov 21.
Solid pseudopapillary neoplasm (SPN) is an extremely rare, low-grade, malignant pancreatic tumour with an excellent prognosis. We describe a case of SPN causing obstructive jaundice in a young female, thus mimicking pancreatic adenocarcinoma clinically and radiologically.
A 32-year-old female presented with abdominal pain for 12 h, icterus, and an epigastric mass measuring 3 × 3 cm. Imaging studies revealed features of pancreatic neoplasm in the head of pancreas, possibly pancreatic adenocarcinoma. However, ultrasound-guided fine-needle aspiration cytology of the lesion revealed were indicative of SPN. The patient was managed by biliary decompression and underwent Whipple procedure for complete tumour resection. Histopathological analysis of the resected specimen confirmed the diagnosis of SPN.
SPN commonly presents in young females with abdominal pain, nausea, and vomiting. Our patient presented with jaundice, which is a rare finding even for pancreatic head tumours. Her clinical and radiological findings indicated pancreatic adenocarcinoma, since it commonly presents with painless jaundice, abdominal pain, and abdominal mass. Diagnostic confirmation is achieved by tissue biopsy - the presence of pseudopapillary patterns is a characteristic feature of SPN. Contrary to pancreatic adenocarcinoma, SPN has an excellent prognosis. Complete tumour resection is the mainstay of treatment for SPN, even in cases of local invasion or metastasis.
SPN poses a diagnostic challenge due to its non-specific presentation. Clinicians should consider SPN as a differential in women presenting with abdominal mass and vague abdominal complaints. Complete surgical resection is the mainstay of treatment for SPN.
实性假乳头状肿瘤（SPN）是一种极其罕见的、低级别恶性胰腺肿瘤，预后良好。我们描述了一例SPN在一名年轻女性中导致梗阻性黄疸的病例，该病例在临床和放射学上酷似胰腺腺癌。
一名32岁女性因腹痛12小时、黄疸以及上腹部有一个3×3厘米的肿块前来就诊。影像学检查显示胰腺头部有胰腺肿瘤的特征，可能是胰腺腺癌。然而，对该病变进行超声引导下细针穿刺细胞学检查显示为SPN。患者接受了胆道减压治疗，并接受了胰十二指肠切除术以完整切除肿瘤。对切除标本的组织病理学分析证实了SPN的诊断。
SPN常见于年轻女性，表现为腹痛、恶心和呕吐。我们的患者出现黄疸，即使对于胰头肿瘤来说这也是一个罕见的表现。她的临床和放射学表现提示为胰腺腺癌，因为胰腺腺癌通常表现为无痛性黄疸、腹痛和腹部肿块。通过组织活检可实现诊断确认——假乳头状结构的存在是SPN的一个特征性表现。与胰腺腺癌相反，SPN预后良好。完整切除肿瘤是SPN的主要治疗方法，即使在存在局部侵犯或转移的情况下也是如此。
由于SPN表现不具特异性，因此构成了诊断挑战。临床医生应将SPN作为出现腹部肿块和模糊腹部不适症状的女性的鉴别诊断之一。完整的手术切除是SPN的主要治疗方法。
