A CASE REPORT OF SOLID PSEUDOPAPILLARY CARCINOMA OF PANCREAS
Dr. Subhosree Dey*, Dr. Baloy Jyoti Talukdar and Dr. Parul Dutta
Background: Solid pseudopapillary neoplasm (SPN) of the pancreas is generally regarded as a low-grade malignant tumour that predominantly develops in young women in the second and third decades of their lives.It is a rare type of tumour accounting for 0.9%-2.7% of all pancreatic tumours. SPN is a pancreatic cancer in which there is no differentiation into a specific cell line, and it is considered an undefined tumour histo- genesis. It has a low-grade malignant potential with excellent post-surgical curative rates and rare metastasis. Despite advances in imaging, pseudocysts and other cystic neoplasms feature in the differential diagnosis. On morphology alone, other primary pancreatic tumours and metastatic tumours pose a diagnostic challenge. Recent advances in immunohistochemical characterization have made the histopathologic diagnosis more specific and, in turn, shed light on the likely histogenesis of this rare tumour. Among the few patients who have died from metastatic SPN are mostly those whose tumours harbour an undifferentiated component characterized by diffuse sheets of cells with increased nuclear atypia and proliferative index. Such high-grade tumours have been subclassified as SPN with foci of high-grade malignant transformation. Case summary: A 54 year old lady presented with epigastric pain. She also complained of mild weakness and frequent episodes of indigestion and bloating. On physical examination, no significant abnormality was detected. Initial laboratory tests revealed a raised white blood cell count, 16 × 109/L, and a high C-reactive protein level of 3 mg/dL, consistent with an inflammatory reaction. Other biochemical values were normal.
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