Solid papillary-cystic tumor of the pancreas

Clinical diagnosis and histopathological findings of a solid papillary-cystic tumor (SCT) of the pancreas may be unrecognized due to difficult differentiation between exocrine and endocrine pancreatic neoplasms, such as acinar cell carcinoma. Surgeons should be aware of this benign but rather uncommon lesion because complete excision is possible and successful.

The clinical course, surgical treatment and morphological findings of 3 patients with SCT are analyzed. The cases comprised 2 females and 1 male ranging in age from 49-72 years. The tumors were identified by histopathologic examination including immunostaining.

The tumors, which were localized in the head, body and tail of the pancreas expressed a distinct immunostaining such as focal alpha1-antitrypsin in cases 1 and 2, and diffuse vimentin in all 3 cases. Keratin reactivity appeared positive in case 2 and 3, and neuroendocrine markers in case 2. The diversity of immunostaining emphasizes the tumor cell phenotype expressing epithelial, mesenchymal, and endocrine lines. After pancreatic resection 2 patients recovered successfully and 1 died. No lymph node or distal metastases were found at autopsy.

Considering the favorable prognosis, the pancreatic SCT should be recognized by clinicians and pathologists, and surgically removed.