Extremely large solid pseudopapillary neoplasm of the pancreas.
Richi Nakatake, Hiroaki Kitade, Hidesuke Yanagida et al.
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Case in brief
A 45-year-old asymptomatic woman was found incidentally to have a large abdominal mass. Tumor markers were within normal limits. CT and MRI showed a well-encapsulated, predominantly cystic pancreatic lesion with heterogeneous contents, focal mural thickening, and restricted diffusion in solid components. Resection pathology confirmed a 22 × 22-cm solid pseudopapillary neoplasm with typical histological and immunohistochemical features. Postoperative portal vein thrombosis was treated successfully with anticoagulation. She was discharged on postoperative day 17 and remained recurrence-free 5 years after surgery.
What made this case unusual
The SPN measured 22 × 22 cm, an exceptionally large size for this tumor; despite its dimensions, pathology showed typical SPN features and the patient remained recurrence-free at 5 years.
Diagnostic / clinical pearl
A very large pancreatic mass can still be an SPN with typical features; tumor size alone should not be taken as evidence of aggressive biological behavior.