Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11382-11391
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11382
Solid pseudopapillary neoplasm of the pancreas in a young male with main pancreatic duct dilatation: A case report
Saki Nakashima, Yoshiki Sato, Tsunao Imamura, Daisuke Hattori, Tetsuo Tamura, Rikako Koyama, Junichiro Sato, Yuta Kobayashi, Masaji Hashimoto
Saki Nakashima, Department of Neurology, The University of Tokyo Hospital, Bunkyo-ku 113-8655, Tokyo, Japan
Yoshiki Sato, Tsunao Imamura, Daisuke Hattori, Tetsuo Tamura, Rikako Koyama, Department of Gastroenterology, Toranomon Hospital, Tokyo 105-0001, Japan
Junichiro Sato, Department of Pathology, Toranomon Hospital, Tokyo 105-0001, Japan
Yuta Kobayashi, Masaji Hashimoto, Department of Gastrointestinal Surgery, Toranomon Hospital, Tokyo 105-0001, Japan
Author contributions: Nakashima S, Sato Y, Imamura T, Koyama R, Tamura T, and Hattori D diagnosed and treated the patient; Kobayashi Y and Hashimoto M manipulated the operation; Sato J diagnosed by pathological aspect; all authors critically revised the report, commented on drafts of the manuscript, and approved the final report.
Informed consent statement: Informed consent was obtained from the patient for being included in this case report.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yoshiki Sato, Doctor, Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-0001, Japan. yoshikisato1217@yahoo.co.jp
Received: August 21, 2021
Peer-review started: August 21, 2021
First decision: September 12, 2021
Revised: September 22, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: December 26, 2021
Processing time: 123 Days and 23.8 Hours
Abstract
BACKGROUND

Solid pseudopapillary neoplasms (SPNs) are rare tumors of the pancreas. Typically, they occur in young females, often have characteristic imaging features, such as cystic components and calcification, and have few effects on the pancreatic duct.

CASE SUMMARY

A 31-year-old man was admitted to our hospital with the chief complaint of epigastric pain. There was only mild tenderness in his upper abdomen, and blood tests showed only a slight increase in alkaline phosphatase. Contrast-enhanced computed tomography showed a 40-mm-diameter, hypovascular mass in the head of the pancreas, and the main pancreatic duct upstream of the mass was severely dilated. Magnetic resonance imaging showed low intensity on T1-weighted images, with high intensity on T2-weighted image in some parts. Pancreatic ductal adenocarcinoma was the primary differential diagnosis. Portal vein infiltration could not be ruled out, so this case was a candidate for neoadjuvant chemotherapy. Subsequently, endoscopic ultrasound-guided fine needle aspiration was performed, and pathological evaluation and immunostaining suggested a diagnosis of SPN. Thus, pancreatoduodenectomy was performed. One year after the operation, the patient is alive with no recurrence.

CONCLUSION

Main pancreatic duct dilatation is usually a finding of suspected pancreatic cancer. However, pancreatic duct dilatation can occur in SPN depending on the location and growth speed. Therefore, SPN should be considered in the differential diagnosis of tumors with pancreatic duct dilatation, and pathological evaluation by endoscopic ultrasound-guided fine needle aspiration should be actively performed.

Keywords: Solid pseudopapillary neoplasm, Endoscopic ultrasound-guided fine-needle aspiration, Main pancreatic duct dilatation, Male, Case report

Core Tip: Main pancreatic duct dilatation is usually a suspected finding of pancreatic cancer. However, pancreatic duct dilatation can occur in solid pseudopapillary neoplasm (SPN) depending on the location and growth speed. Therefore, SPN should be considered as one of the differential diagnoses of tumors with pancreatic duct dilatation, and pathological evaluation by endoscopic ultrasound-guided fine needle aspiration should be actively performed.