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Solid cystic pseudopapillary tumor of the pancreas: report of one case
Hean-Pat Saw1, Mao-Lin Ho, Jia-Yuh Chen
1Department of Pediatrics, Cheng-Ching Hospital, Taiwan.
Insights
A rare pancreatic tumor, Frantz's tumor, was diagnosed in a 12-year-old. Surgical resection led to a good prognosis, with no recurrence noted after one year of follow-up.
Area of Science:
- Pediatric oncology
- Gastrointestinal surgery
- Pathology
Background:
- Solid cystic pseudopapillary tumors (SCPTs), also known as Frantz's tumor, are uncommon pancreatic neoplasms.
- Pediatric cases of SCPTs are exceptionally rare, often presenting with vague or absent initial symptoms.
Observation:
- A 12-year-old presented with acute gastrointestinal symptoms including abdominal pain, vomiting, and appetite loss.
- Computed tomography revealed a large (6 x 7 x 7 cm) pancreatic mass in the right upper quadrant.
- The tumor exhibited cystic degeneration and hemorrhagic necrosis, with a mixed solid and papillary microscopic architecture.
Findings:
- Complete surgical resection via Whipple operation with pylorus-preserved pancreato-duodenectomy and cholecystectomy was successfully performed.
- Post-operative pathological examination confirmed the diagnosis of solid cystic pseudopapillary tumor.
- The patient demonstrated a favorable outcome with no recurrence or malignant changes observed at one-year follow-up.
Implications:
- Complete resection offers a good prognosis for pediatric SCPTs.
- Long-term surveillance is crucial due to the potential for tumor recurrence.
- This case underscores the importance of considering rare pancreatic neoplasms in pediatric differential diagnoses.
Abstract:
Solid cystic pseudopapillary tumors of the pancreas (Frantz's tumor) are rare in children. We present a 12-year-old child with a pancreatic tumor without initial symptoms or signs until the tumor compressed the adjacent organs. The child had clinical presentation of intermittent abdominal cramping pain, vomiting, changes in bowel habits and decreased of appetite for 2 days. The abdominal computed tomography showed a mass that measuring 6 x 7 x 7 cm at the right upper quadrate. Whipple operations with pylorus-preserved pancreato-duodenectomy and cholecystectomy were performed. The definite diagnosis was made by the post-operation pathological finding. Grossly, the tumor was encapsulated with cystic degeneration and hemorrhagic necrosis appearance. Microscopically, it had predominantly papillary arrangement mixed with solid areas. Prognosis of this tumor was good under complete resection. The patient remained well with no signs of recurrence or malignant changes at 1 year after operation. Due to the possibility of recurrence, close follow up is recommended.
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