Surgical Management of Solid Pseudo Papillary tumor of Pancreas - A rare case report

Abstract

Background Solid pseudo papillary neoplasia (SPN) of the pancreas is an extremely rare epithelial tumor of low malignant potential. SPN accounts for less than 1 to 2 of exocrine pancreatic tumors. The aim of this Case report is to enumerate our experience with SPN of the pancreas of a young female patient and to give a brief review of literature. Case ReportA 21 year young girl with symptom of vague abdominal pain in the epigastric region for 30 days with no other symptoms presented to us. On Abdomen Examination no mass was palpable. USG and CECT scan done showed a well capsulated mass lesion in tail of pancreas of size 7cmx 9cm x 9cm dimension. The lesion was hetero dense with no vascular or adjacent organ involvement. Endoscopic FNAC was done which showed the diagnosis of Solid Pseudo         papillary neoplasm. With this diagnosis, we proceeded with distal pancreatectomy and Splenectomy. Post-operative  period was uneventful. Patient recovered well and discharged on 10th Post op day. The specimen report came as SPN with IHC positive for Vimentin and Neuron Specific Enolase. The margins are clear and no nodes are positive. Hence no             adjuvant Chemotherapy given. The patient is on follow up past one year without any recurrence. Conclusion Solid Pseudo papillary tumors must be diagnosed with high index of suspicion because of their rarity and all these patients must be taken up for Surgical removal. Surgery must aim at                removing as much as the tumor as possible with negative margins and in cases where there is extensive involvement de-bulking surgeries also provide definitive improvement in survival.