Diagnosis of a solid pseudopapillary neoplasm using EUS-FNA

Area of Science:

• Gastroenterology and Surgical Oncology
• Diagnostic Imaging and Interventional Endoscopy

Background:

• Pancreatic masses require accurate preoperative diagnosis for optimal treatment planning.
• Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor, often presenting with ambiguous imaging features.
• Differentiating SPN from other pancreatic neoplasms, such as neuroendocrine tumors, can be challenging.

Observation:

• A 40 mm pancreatic mass with cystic and calcified components was identified on abdominal ultrasound.
• Initial imaging raised suspicion for SPN but could not exclude a neuroendocrine tumor.
• The patient underwent endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) for diagnosis.

Findings:

• EUS-FNA was performed to differentiate between suspected SPN and neuroendocrine tumor.
• A minimized resection, specifically a segmental pancreatectomy, was conducted to confirm the SPN diagnosis.
• The combination of imaging, EUS-FNA, and surgical resection provided a definitive preoperative diagnosis.

Implications:

• Accurate preoperative diagnosis of SPN is crucial for determining the appropriate surgical approach.
• EUS-FNA plays a vital role in the preoperative characterization of pancreatic lesions.
• This case highlights the importance of integrated diagnostic methods for managing complex pancreatic tumors.