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Synchronous solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm of the pancreas: Report of a case

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Abstract

Solid pseudopapillary neoplasm (SPN) of the pancreas, most commonly found in young female subjects, is a rare neoplasm with low potential for malignancy. We report an unusual case of a 66-year-old male patient who had a simultaneous malignant SPN and an intraductal papillary mucinous adenoma (IPMA) of the pancreas. The patient was admitted to our department for the evaluation of the main solid tumor with calcification and small multilocular cystic lesions apart from the main tumor in the pancreatic head. We performed pylorus-preserving pancreaticoduodenectomy to treat the calcified tumor and multilocular cystic lesions. The diagnosis of malignant SPN was confirmed on the basis of histological invasion to the adjacent structures. The separate cystic lesions were diagnosed as a branch-type IPMA. The synchronous occurrence of IPMA and SPN in the present case did not demonstrate that there were tumors maintained through the common abnormal Wnt signaling pathway by immunohistochemical study. To our knowledge, this is the first known case of synchronous SPN and IPMA of the pancreas.

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References

  1. Franz VK. Tumors of the pancreas. Vol. 7, fascicle 27 and 28. Washington, DC: Armed Forces Institute of Pathology; 1959.

    Google Scholar 

  2. Klöppel G, Lüttges J, Klimstra DS, Hruban R, Kern S, Adler G. Solid-pseudopapillary neoplasm. In: Hamilton SR, Aaltonen LA, editors. World Health Organization classification of tumours: pathology and genetics of tumours of the digestive system. Lyon, France: IARC Press; 2000. p. 246–248.

    Google Scholar 

  3. Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. J Am Coll Surg 2005;200:965–972.

    Article  PubMed  Google Scholar 

  4. Mortenson MM, Katz MH, Tamm EP, Bhutani MS, Wang H, Evans DB, et al. Current diagnosis and management of unusual pancreatic tumors. Am J Surg 2008;196:100–113.

    Article  PubMed  Google Scholar 

  5. Campbell F, Azadeh B. Cystic neoplasms of the exocrine pancreas. Histopathology 2008;52:539–551.

    Article  PubMed  CAS  Google Scholar 

  6. Lee JH, Yu JS, Kim H, Kim JK, Kim TH, Kim KW, et al. Solid pseudopapillary carcinoma of the pancreas: differentiation from benign solid pseudopapillary tumour using CT and MRI. Clin Radiol 2008;63:1006–1014.

    Article  PubMed  CAS  Google Scholar 

  7. Jhala N, Siegal GP, Jhala D. Large, clear cytoplasmic vacuolation: an under-recognized cytologic clue to distinguish solid pseudopapillary neoplasms of the pancreas from pancreatic endocrine neoplasms on fine-needle aspiration. Cancer 2008;114:249–254.

    Article  PubMed  Google Scholar 

  8. Nakagohri T, Kinoshita T, Konishi M, Takahashi S, Gotohda N. Surgical outcome of solid pseudopapillary tumor of the pancreas. J Hepatobiliary Pancreat Surg 2008;15:318–321.

    Article  PubMed  Google Scholar 

  9. Gedaly R, Toledano A, Millan G, Essenfeld H, Zambrano VJ. Treatment of liver metastases from a solid pseudopapillary tumor of the pancreas. J Hepatobiliary Pancreat Surg 2006;13:587–590.

    Article  PubMed  Google Scholar 

  10. Martin RC, Klimstra DS, Brennan MF, Conlon KC. Solid-pseudopapillary tumor of the pancreas: a surgical enigma? Ann Surg Oncol 2002;9:35–40.

    Article  PubMed  Google Scholar 

  11. Shimizu T, Murata S, Mekata E, Miyake T, Abe H, Kurumi Y, et al. Clinical potential of an antitumor drug sensitivity test and diffusion-weighted MRI in a patient with a recurrent solid pseudopapillary tumor of the pancreas. J Gastroenterol 2007;42:918–922.

    Article  PubMed  CAS  Google Scholar 

  12. Maffuz A, Bustamante Fde T, Silva JA, Torres-Vargas S. Preoperative gemcitabine for unresectable, solid pseudopapillary tumour of the pancreas. Lancet Oncol 2005;6:185–186.

    Article  PubMed  Google Scholar 

  13. Santini D, Poli F, Lega S. Solid-papillary tumors of the pancreas: histopathology. JOP 2006;7:131–136.

    PubMed  Google Scholar 

  14. Abraham SC, Klimstra DS, Wilentz RE, Yeo CJ, Conlon K, Brennan M, et al. Solid-pseudopapillary tumors of the pancreas are genetically distinct from pancreatic ductal adenocarcinomas and almost always harbor beta-catenin mutations. Am J Pathol 2002;160:1361–1369.

    Article  PubMed  CAS  Google Scholar 

  15. Heiser PW, Cano DA, Landsman L, Kim GE, Kench JG, Klimstra DS, et al. Stabilization of beta-catenin induces pancreas tumor formation. Gastroenterology 2008;135:1288–1300.

    Article  PubMed  CAS  Google Scholar 

  16. Serra S, Chetty R. Revision 2: an immunohistochemical approach and evaluation of solid pseudopapillary tumour of the pancreas. J Clin Pathol 2008;61:1153–1159.

    Article  PubMed  CAS  Google Scholar 

  17. Tien YW, Ser KH, Hu RH, Lee CY, Jeng YM, Lee PH. Solid pseudopapillary neoplasms of the pancreas: is there a pathologic basis for the observed gender differences in incidence? Surgery 2005;137:591–596.

    Article  PubMed  Google Scholar 

  18. Machado MC, Machado MA, Bacchella T, Jukemura J, Almeida JL, Cunha JE. Solid pseudopapillary neoplasm of the pancreas: distinct patterns of onset, diagnosis, and prognosis for male versus female patients. Surgery 2008;143:29–34.

    Article  PubMed  Google Scholar 

  19. 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;23:1045–1050.

    Article  PubMed  CAS  Google Scholar 

  20. Nishimori I, Kohsaki T, Tochika N, Takeuchi T, Minakuchi T, Okabayashi T, et al. Non-cystic solid-pseudopapillary tumor of the pancreas showing nuclear accumulation and activating gene mutation of beta-catenin. Pathol Int 2006;56:707–711.

    Article  PubMed  CAS  Google Scholar 

  21. Takahashi Y, Hiraoka N, Onozato K, Shibata T, Kosuge T, Nimura Y, et al. Solid-pseudopapillary neoplasms of the pancreas in men and women: do they differ? Virchows Arch 2006;448:561–569.

    Article  PubMed  Google Scholar 

  22. Tang LH, Aydin H, Brennan MF, Klimstra DS. Clinically aggressive solid pseudopapillary tumors of the pancreas: a report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases. Am J Surg Pathol 2005;29:512–519.

    Article  PubMed  Google Scholar 

  23. Nishihara K, Nagoshi M, Tsuneyoshi M, Yamaguchi K, Hayashi I. Papillary cystic tumors of the pancreas. Assessment of their malignant potential. Cancer 1993;71:82–92.

    Article  PubMed  CAS  Google Scholar 

  24. Goh BK, Ooi LL, Kumarasinghe MP, Tan YM, Cheow PC, Chow PK, et al. Clinicopathological features of patients with concomitant intraductal papillary mucinous neoplasm of the pancreas and pancreatic endocrine neoplasm. Pancreatology 2006;6:520–526.

    Article  PubMed  Google Scholar 

  25. Chetty R, Serra S, Salahshor S, Alsaad K, Shih W, Blaszyk H, et al. Expression of Wnt-signaling pathway proteins in intraductal papillary mucinous neoplasms of the pancreas: a tissue microarray analysis. Hum Pathol 2006;37:212–217.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Naoya Imamura, Kazuo Chijiiwa, Jiro Ohuchida, Masahide Hiyoshi & Nobuyasu Takahashi

  2. Section of Oncopathology and Regenerative Biology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan

    Kenji Yorita & Hiroaki Kataoka

Authors
  1. Naoya Imamura
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  2. Kazuo Chijiiwa
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  3. Jiro Ohuchida
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  4. Masahide Hiyoshi
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  5. Nobuyasu Takahashi
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  6. Kenji Yorita
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  7. Hiroaki Kataoka
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Imamura, N., Chijiiwa, K., Ohuchida, J. et al. Synchronous solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm of the pancreas: Report of a case. Surg Today 41, 865–871 (2011). https://doi.org/10.1007/s00595-010-4361-6

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  • DOI: https://doi.org/10.1007/s00595-010-4361-6

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