Solid and papillary neoplasm of the pancreas. Report of three cases from Taiwan

During a 2-year period, three young Chinese women in Taiwan were found to have a rare pancreatic tumor known as solid and papillary neoplasm of the pancreas. They had a large abdominal mass, found either incidentally or because of abdominal discomfort. Endoscopic retrograde cholangiopancreatography was useful in localizing the tumor. Grossly, the tumors all appeared well circumscribed with focal or extensive cystic change and hemorrhage. Microscopically, they were composed of small uniform eosinophilic cells forming papillary, microcystic, and solid structures with extensive hemorrhage resulting in necrosis and formation of cholesterol granulomas. No carcinoembryonic antigen was demonstrated by the immunoperoxidase method. None of these three patients experienced recurrence more than 2 years after surgery. Even the one who received only drainage and cyst-jejunostomy has been doing well. Long survival or even cure can be expected, but the accumulated experiences indicate that this neoplasm should be regarded as a low-grade, potentially malignant tumor. One of the patients developed diabetes mellitus postoperatively.