Rare Solid pseudo-papillary neoplasm of pancreas diagnosed on endoscopic ultrasound guided fine needle aspiration, with histopathological and immunohistochemical confirmation - series of four cases.

Dr. Zubaida Rasool; Dr. Suhail Mushtaq Wani; Dr. Nuzhat Samoon; Dr. Sumat Malik; Dr. Salma Gul; Dr. Majid Khan; Dr. Omer Javaid Shah; Dr. Sadaf Ali Bangri

Volume : VII, Issue : V, May - 2018

Rare Solid pseudo-papillary neoplasm of pancreas diagnosed on endoscopic ultrasound guided fine needle aspiration, with histopathological and immunohistochemical confirmation - series of four cases.

Dr. Zubaida Rasool, Dr. Suhail Mushtaq Wani, Dr. Nuzhat Samoon, Dr. Sumat Malik, Dr. Salma Gul, Dr. Majid Khan, Dr. Omer Javaid Shah, Dr. Sadaf Ali Bangri

Abstract :

Solid pseudo papillary neoplasm of pancreas is very rare tumor and accounts for 0.17–2.7 % of all neuroendocrine tumor of pancreas. We report four cases of this neoplasm, which presented to our department within one year duration. Our first case is a 19 year old female who developed abdominal pain of two days duration and CECT abdomen revealed heterogeneously enhancing mass in the pancreatic duodenal groove (head of pancreas). Second patient, was an 18 years old female who also presented with diffuse abdominal pain. CECT revealed heterogeneously enhancing pancreatic head mass. Third patient, a 45 years old female known case of Sheehans syndrome and hypothyroidism presented with intermittent pain abdomen from last three months. Computed tomography revealed large hypodense lesion in right lumbar region measuring 12x12 cm with calcification within the mass along with a hypodense lesion in segment 5 of liver measuring 2 cm. Fourth patient a 17 years old female presented with chief complaints of abdominal pain intermittent in nature for fifteen days. The routine laboratory tests revealed no deviation from the normal values. A computed tomography scan was performed which showed a heterogeneously enhancing mass in the uncinate process of pancreas which measured 2x3 cm. These lesions were excised and sent for histopathological examination which revealed features which were consistent with the diagnosis of solid pseudo papillary neoplasm of pancreas in all four cases. Subsequent immunohistochemistry evaluation was carried out which confirmed the diagnosis in all four cases.