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Solid pseudopapillary neoplasm of the pancreas causing obstructive jaundice: Case report of a rare entity

Year: 2024

Type: article

Abstract: INTRODUCTION: Solid pseudopapillary neoplasm (SPN) is an extremely rare, low-grade, malignant pancreatic tumour with an excellent prognosis. We describe a case of SPN causing obstructive jaundice in a young female, thus mimicking pancreatic adenocarcinoma clinically and radiologically. CASE PRESENTATION: A 32-year-old female presented with abdominal pain for 12 h, icterus, and an epigastric mass measuring 3 × 3 cm. Imaging studies revealed features of pancreatic neoplasm in the head of pancreas, possibly pancreatic adenocarcinoma. However, ultrasound-guided fine-needle aspiration cytology of the lesion revealed were indicative of SPN. The patient was managed by biliary decompression and underwent Whipple procedure for complete tumour resection. Histopathological analysis of the resected specimen confirmed the diagnosis of SPN. DISCUSSION: SPN commonly presents in young females with abdominal pain, nausea, and vomiting. Our patient presented with jaundice, which is a rare finding even for pancreatic head tumours. Her clinical and radiological findings indicated pancreatic adenocarcinoma, since it commonly presents with painless jaundice, abdominal pain, and abdominal mass. Diagnostic confirmation is achieved by tissue biopsy - the presence of pseudopapillary patterns is a characteristic feature of SPN. Contrary to pancreatic adenocarcinoma, SPN has an excellent prognosis. Complete tumour resection is the mainstay of treatment for SPN, even in cases of local invasion or metastasis. CONCLUSION: SPN poses a diagnostic challenge due to its non-specific presentation. Clinicians should consider SPN as a differential in women presenting with abdominal mass and vague abdominal complaints. Complete surgical resection is the mainstay of treatment for SPN.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2024.110635

Authors: Rick Maity, Arkadeep Dhali, Prajes Kumar Chattopadhyay, Jyotirmoy Biswas, Gopal Krishna Dhali