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• W2978162240 abstract "Introduction: Solid pseudopapillary neoplasm is an uncommon pancreatic neoplasm with low malignant potential that occurs predominantly in young women. Incidence in males or the pediatric population is unusual; presentation as acute pancreatitis is atypical. Case Report: A 12-year-old boy with no past medical history presented to the emergency department with four months of progressive epigastric abdominal pain and nausea. Initial evaluation showed an elevated lipase of 758 units/liter, with normal complete blood count and full metabolic profile. Contrasted computerized tomographic scan of the abdomen and pelvis revealed a round 3.8 x 3.7 x 3.8 cm homogenously enhancing mass centered in the head of the pancreas, with dilation of the proximal pancreatic duct to 4 mm (Fig 1). Endoscopic ultrasound showed a 3.5 x 3.5 cm mass in the head of the pancreas, which was hypoechoic and homogenous with well-defined borders (Fig 2). Fine-needle aspiration of the lesion revealed poorly cohesive monomorphic epithelial cells forming solid and pseudopapillary structures consistent with solid pseudopapillary neoplasm (Fig 3A-C). The patient underwent a Whipple procedure. Final histopathology confirmed the diagnosis.Figure 1Figure 2Figure 3Discussion: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare epithelial neoplasms of low malignant potential constituting < 2% of all exocrine pancreatic tumors. SPN presenting as acute pancreatitis in an adolescent male is rare; they predominantly occur in young women (90% of neoplasms) with a mean age of 35 years. Roughly 22-33% of cases occur in children, with an average age of 13-15 years old at diagnosis with a female preponderance. Adults commonly present with abdominal pain, followed by nausea, vomiting, and weight loss; a palpable mass is the most common presentation in children. Only 7-20% of all cases present with acute pancreatitis. On cross-sectional imaging, SPNs classically present as a large, solitary, well-circumscribed lesion, with a cystic, mixed cystic/solid, or purely solid appearance. On endoscopic ultrasound, SPNs most commonly appear as well-demarcated, hypoechoic, solid-appearing lesions. Percutaneous fine-needle aspiration was the traditional means of pre-operative diagnosis; however, over the past 25 years EUS-guided FNA has steadily increased, and reported accuracy is as high as 75%. Primary treatment of SPN is surgical resection, which is curative upon complete excision of the lesion." @default.
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• W2978162240 date "2016-10-01" @default.
• W2978162240 modified "2023-09-25" @default.
• W2978162240 title "Solid Pseudopapillary Neoplasm of the Pancreas: Not Just for the Girls" @default.
• W2978162240 doi "https://doi.org/10.14309/00000434-201610001-01228" @default.
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