Peritoneal and nodal recurrence 7 years after the excision of a ruptured solid pseudopapillary neoplasm of the pancreas: report of a case.
A solid pseudopapillary neoplasm (SPN) of the pancreas is generally regarded as a neoplasm of low malignant potential and there is rarely recurrence of the disease. A 12-year-old female underwent a pylorus preserving pancreaticoduodenectomy for a ruptured pancreatic SPN following a blunt abdominal trauma. The tumor showed no pathological features suggesting malignant potential. Follow-up imaging studies depicted small nodules adjacent to the superior mesenteric vein 7 years after surgery. A laparotomy was performed, and exploration revealed 3 nodules adjacent to the superior mesenteric vein and 4 small nodules in the mesointestine. All of these lesions were extirpated, and were histologically confirmed to be nodal and peritoneal recurrence of SPN. This case indicates that SPN of the pancreas has a latent ability to recur, regardless of its benign pathological features, and peritoneal spread may be promoted by trauma. A close postoperative follow-up is thus mandatory in all patients with SPN even after a radical resection.
Department of Surgery, Nagasaki Municipal Hospital, 6-39 Shinchi, Nagasaki, 850-8555, Japan. ytajima@med.shimane-u.ac.jp
Yoshitsugu
Y
Tajima
Norihiro
N
Kohara
Junpei
J
Maeda
Keiji
K
Inoue
Amane
A
Kitasato
Kouji
K
Natsuda
Junji
J
Irie
Tomohiko
T
Adachi
Tamotsu
T
Kuroki
Susumu
S
Eguchi
Takashi
T
Kanematsu
D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D010179:Pancreas / Q000293:injuries; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary*; D012421:Rupture