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Pre-operative diagnosis of synchronous solid-pseudopapillary neoplasms of the pancreas

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Abstract

We report the case of a 37-year-old woman with two synchronous solid-pseudopapillary neoplasms (SPNs) of the pancreas. The patient underwent abdominal echography as part of the screening for hepatitis C virus antibody positivity, and a pancreatic tail tumor was detected. She was referred to our hospital for further examination of the pancreatic tail tumor. There were two masses measuring 37 and 20 mm, in the pancreatic body and tail, respectively, which were slightly enhanced on abdominal computed tomography. On endoscopic ultrasonography (EUS), their surfaces were smooth, their margins were clear, anechoic spots were seen in the hypoechoic mass, and there were no lateral shadows. Magnetic resonance imaging showed a low- and high-intensity mass of the body and a low- and low-intensity mass of the tail on T1- and T2-weighted images, respectively. EUS-guided fine needle aspiration biopsy (EUS-FNA) suggested SPNs because the tumor cells showed an aberrant nuclear expression of β-catenin and loss of membranous staining of E-cadherin on immunohistochemical analysis. With a diagnosis of SPNs based on the EUS-FNA findings, a distal pancreatectomy was performed. On histopathologic examination of the resected specimen, the SPNs were arising synchronously.

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Authors and Affiliations

  1. Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan

    Kazuya Matsumoto, Kazuo Hara, Akira Sawaki, Nobumasa Mizuno, Susumu Hijioka, Shinya Kondo & Kenji Yamao

  2. Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan

    Yasumasa Niwa, Masahiro Tajika & Hiroki Kawai

  3. Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya, Japan

    Yasuhiro Shimizu

  4. Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan

    Waki Hosoda & Yasushi Yatabe

  5. Second Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan

    Kazuya Matsumoto

Authors
  1. Kazuya Matsumoto
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  2. Kazuo Hara
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  3. Akira Sawaki
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  4. Nobumasa Mizuno
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  5. Susumu Hijioka
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  6. Shinya Kondo
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  7. Yasumasa Niwa
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  8. Masahiro Tajika
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  9. Hiroki Kawai
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  10. Yasuhiro Shimizu
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  11. Waki Hosoda
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  12. Yasushi Yatabe
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  13. Kenji Yamao
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Corresponding author

Correspondence to Kenji Yamao.

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Matsumoto, K., Hara, K., Sawaki, A. et al. Pre-operative diagnosis of synchronous solid-pseudopapillary neoplasms of the pancreas. Clin J Gastroenterol 3, 301–306 (2010). https://doi.org/10.1007/s12328-010-0173-x

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  • DOI: https://doi.org/10.1007/s12328-010-0173-x

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