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Solid pseudopapillary tumor of the pancreas

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Abdominal pain and a palpable mass in the upper abdomen.

Patient Data

Age: 15 years
Gender: Female

Large heterogeneous mass in the epigastrium extending into the right upper quadrant.

Nonhepatic derived.

Huge heterogeneous mass arising from the head of the pancreas with cystic elements compressing the IVC.

Double duct sign evident - dilated CBD and pancreatic duct.

 

Huge mass arising from the head of the pancreas without internal diffusion restriction.

Double duct sign evident - dilated CBD and pancreatic duct.  Mild intrahepatic duct dilatation.

FNAC sample

Giemsa Stain: Cellular specimen showing solid and papillary fragments with myxoid stromal cores, and bland round-oval epithelial nuclei.

The pancreatic mass was resected en bloc with a segment of adherant transverse colon ( stitch ).

Case Discussion

Solid pseudopapillary tumor of the pancreas ( Franz ) tumor is a rare pancreatic mass almost exclusively in females typically in the 2-3rd decades of life.

The mass is typically large at presentation, well encapsulated and has both solid and cystic elements.   Ductal obstruction is infrequently identified.

The histological appearances are characteristic and from which the tumor derives its name.

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