A case of pancreatic solid-pseudopapillary neoplasm with marked ossification

A cystic lesion of the pancreas was detected in a 25-year-old asymptomatic woman during a company medical checkup. Abdominal computed tomography (CT) revealed an ossified lesion in the pancreatic body, and the patient was referred to us for further management. Abdominal ultrasound and endoscopic ultrasound showed a hypoechoic mass with a large ossific focus, measuring 25 mm in the pancreatic body. CT and magnetic resonance imaging (MRI) showed a nonenhancing tumor lesion with a large calcific focus, measuring 20 mm in the pancreatic body. Endoscopic retrograde pancreatography revealed mild stenosis of the main pancreatic duct near the ossific focus in the pancreatic body. From the above, a pancreatic solid-pseudopapillary neoplasm (SPN) was suspected, and resection of the pancreatic body was performed. Intraoperatively, a whitish tumor measuring about 20 mm was recognized. Histopathologically, moderately large-sized tumor cells containing eosinophilic cytoplasm were arranged in a pseudopapillary formation, and infiltrated the surrounding normal tissue with ossification. Immunostaining was positive for α1-antitrypsin, not inconsistent with the diagnosis of SPN. We report this case of pancreatic SPN with ossification and a review of the literature.