Published: 2022-10-29

Solid pseudopapillary neoplasm, a rare pancreatic tumor-case report

Megha A. Dhamale, Ninad J. Gadekar, Jayant M. Gadekar, Bhagwan K. Aname


The uncommon cystic exocrine pancreatic tumor known as solid pseudopapillary epithelial neoplasm (SPEN) most frequently affects young females. We provide a case study of a 17-year-old female who experienced intermittent vomiting and epigastric pain. Her laboratory results were within normal ranges, and a clinical abdominal exam revealed pain in the region of epigastrium. A 40×3×31 mm iso-hyperdense minimally enhancing solid mass with well-defined borders was detected on her CECT scan. Nothing calcified. neither localized lymphadenopathy nor fat stranding. It was just next to the splenic vein, which was completely opaque. Her histopathology revealed a solid pseudopapillary pancreatic tumor after she underwent a spleen preserving distal pancreatectomy. Beta-catenin and vimentin IHC assays were significantly positive, confirming the diagnosis and she was on a regular follow-up. As of now, the patient is asymptomatic and has not experienced a recurrence. In contrast to other forms of pancreas tumors, SPEN is treatable with early identification and full surgical resection.


Pancreas, Pseudopapillary neoplasm, Distal pancreatectomy

Full Text:



Frantz VK. Tumours of the pancreas. Armed Forces Institute Pathol. 1959.

Bochis OV, Bota M, Mihut E, Buiga R, Hazbei DS, Irimie A. Solid pseudopapillary tumour of the pancreas: clinical-pathological features and management of 13 cases. Clujul Med. 2017;90(2):171.

Klöppel G, Solcia E, Longnecker DS, Sobin LE, Capella C. Histological typing of tumours of the exocrine pancreas. Springer Sci Business Media. 1996.

Lam KY, Lo CY, Fan ST. Pancreatic solid-cystic-papillary tumor: clinicopathologic features in eight patients from Hong Kong and review of the literature. World J Surg. 1999;23(10):1045-50.

Huang HL, Shih SC, Chang WH, Wang TE, Chen MJ, Chan YJ. Solid-pseudopapillary tumor of the pancreas: clinical experience and literature review. World journal of gastroenterology: WJG. 2005;11(9):1503.

Kosmahl M, Seada LS, Jänig U, Harms D, Klöppel G. Solid–pseudopapillary tumor of the pancreas: its origin revisited. Virchows Archiv. 2000;436(5):473-80.

Reddy S, Cameron JL, Scudiere J, Hruban RH, Fishman EK, Ahuja N et al. Surgical management of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi tumors): a large single-institutional series. J Am College Surgeons. 2009;208(5):950-7.

Cecka F, Jon B, Subrt Z, Ferkol A. Solid pseudopapillary tumour of the pancreas: diagnosis, treatment, and prognosis. Acta Chirurgica Belgica. 2014;114(1):58-62.

Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. J Am College Surgeons. 2005;200(6):965-72.

Frago R, Fabregat J, Jorba R, García-Borobia F, Altet J, Serrano MT, Valls C. Solid pseudopapillary tumors of the pancreas: diagnosis and curative treatment. Revista Espanola de Enfermedades Digestivas. 2006;98(11):809.

Zuriarrain A, Nir I, Bocklage T, Rajput A. Pseudopapillary tumor of the pancreas in a 17-year-old girl. J Clin Oncol. 2011;29(14):e395-6.

Mao C, Guvendi M, Domenico DR, Kim K, Thomford NR, Howard JM. Papillary cystic and solid tumors of the pancreas: a pancreatic embryonic tumor? Studies of three cases and cumulative review of the world's literature. Surgery. 1995;118(5):821-8.

Bardales RH, Stelow EB, Mallery S, Lai R, Stanley MW. Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology. Diagnostic Cytopathol. 2006;34(2):140-75.

Shimizu M, Matsumoto T, Hirokawa M, Monobe Y, Iwamoto S, Tsunoda T et al. Solid‐pseudopapillary carcinoma of the pancreas. Pathol Int. 1999;49(3):231-4.

Adams AL, Siegal GP, Jhala NC. Solid pseudopapillary tumor of the pancreas: a review of salient clinical and pathologic features. Adv Anatomic Pathol. 2008;15(1):39-45.

Yu PF, Hu ZH, Wang XB, Guo JM, Cheng XD, Zhang YL et al. Solid pseudopapillary tumor of the pancreas: a review of 553 cases in Chinese literature. World J Gastroenterol. 2010;16(10):1209.

Cantisani V, Mortele KJ, Levy A, Glickman JN, Ricci P, Passariello R et al. MR imaging features of solid pseudopapillary tumor of the pancreas in adult and pediatric patients. Am J Roentgenol. 2003;181(2):395-401.

Zhang H, Liang TB, Wang WL, Shen Y, Ren GP, Zheng SS. Diagnosis and treatment of solid-pseudopapillary tumor of the pancreas. Hepatobiliary Pancreatic dis Int. 2006;5(3):454-8.

Notohara K, Hamazaki S, Tsukayama C, Nakamoto S, Kawabata K, Mizobuchi K et al. Solid-pseudopapillary tumor of the pancreas: immunohistochemical localization of neuroendocrine markers and CD10. Am J Surg Pathol. 2000;24(10):1361-71.

Coelho JC, da Costa MA, Ramos EJ, Torres AR, Savio MC, Claus CM. Surgical management of solid pseudopapillary tumor of the pancreas. J Society Laparoendoscopic Surg. 2018;22(4).

Wang WB, Zhang TP, Sun MQ, Peng Z, Chen G, Zhao YP. Solid pseudopapillary tumor of the pancreas with liver metastasis: clinical features and management. Eur J Surg Oncol. 2014;40(11):1572-7.

Cai Y, Ran X, Xie S, Wang X, Peng B, Mai G, Liu X. Surgical management and long-term follow-up of solid pseudopapillary tumor of pancreas: a large series from a single institution. J Gastrointestinal Surg. 2014;18(5):935-40.

Zhang H, Wang W, Yu S, Xiao Y, Chen J. The prognosis and clinical characteristics of advanced (malignant) solid pseudopapillary neoplasm of the pancreas. Tumor Biol. 2016;37(4):5347-53.

Daouadi M, Zureikat AH, Zenati MS, Choudry H, Tsung A, Bartlett DL et al. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg. 2013;257(1):128-32.

Soares-Junior C, Gomes CA, Peixoto RD, Gomes CC, Juste LA. Spleen-preserving distal pancreatectomy in the management of solid papillary-cystic tumor of the pancreas: case report and literature review. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2010;23:206-8.