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Journal of Case Reports
Histopathology of Pancreatic Solid Pseudo-papillary Neoplasm Failed to Predict Metastatic Potential: A Case Report of 2 Cases from a Tertiary Care Centre
Anuradha Sekaran1, Abid Hussain1, Partha Pal2, Duvuru Nageshwara Reddy2
Departments of 1Pathology and 2Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.
Corresponding Author:
Dr Abid Hussain
Email: hussain.abid111@gmail.com
Received: 05-MAY-2018 Accepted: 23-OCT-2018 Published Online: 05-NOV-2018
DOI: http://dx.doi.org/10.17659/01.2018.0068
Background: Solid pseudo-papillary neoplasm (SPN) of the pancreas is a rare cystic tumor of pancreas which usually affects young females. Most patients remain asymptomatic for many years prior to diagnosis. Moreover, only rarely, the disease can be locally advanced or metastatic at presentation. Case Report: We report our experience with two cases of SPN of the pancreas with metastasis to liver and peritoneum at the time of presentation. Both were young females who presented with intermittent abdominal pain. Tumor’s size ranged from 6.3-7 cm in greatest dimension. One case was diagnosed pre-operatively through percutaneous core needle biopsy and the other case had a fine needle aspiration done and later underwent surgery because of high suspicion of SPN based on clinical and radiological findings. By immuno-histochemistry, all cases stained strongly positive for pancytokeratin, vimentin, CD10, beta-catenin (nuclear) and neuroendocrine markers (synaptophysin). However, they were negative for chromogranin and CA19.9. Though these cases showed metastasis, the proliferation index (Ki-67) was very low <3% in both the cases. Conclusion: SPN of the pancreas should be considered in the differential diagnosis of any solid and partly cystic pancreatic or upper abdominal mass, particularly in young females. Histopathological features of metastatic potential of SPN have been predicted by several factors however they could not predict metastasis in our cases.
Keywords : Abdominal Pain, Fine Needle Biopsy, Immunohistochemistry, Pancreas, Pancreatic Neoplasms, Peritoneum, Vimentin.
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