title: Successful selective internal radiotherapy (SIRT) in a patient with a malignant solid pseudopapillary pancreatic neoplasm (SPN).
abstract: Solid pseudopapillary neoplasms of the pancreas (SPNs, Gruber-Frantz-Tumor) are a rare entity representing 1-5% of all exocrine pancreatic tumors. The pseudocystic lesions preferentially affect young females <30 years, are mostly benign (∼90%) and normally present with unspecific symptoms. We describe the case of a 16-years-old Asian woman that was initially diagnosed with an SPN in the pancreatic head with mesenterial and hepatic metastases. After diagnosis, an extensive tumor resection was performed including pyloric-preserving pancreatic head resection followed by sequential resection of all hepatic metastases. After the patient was diagnosed with a hepatic recurrence and high intrahepatic tumor load, we chose a multimodal procedure and performed a selective internal radiotherapy (SIRT). Four years after SIRT and 10 years after initial diagnosis of metastatic SPN, the patient is in a good condition without any evidence for hepatic recurrence. This case represents a rare clinical course of a malignant and invasive SPN with an exceptionally long survival despite of high initial tumor burden. The selective internal radiotherapy is a suitable approach for inducing long-term remissions of the strongly vascularized liver metastases.
authors.affiliation: Department of Gastroenterology, Endocrinology and Metabolism, Philipps-University Marburg, Marburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Krug
authors.forename: D K
authors.initials: DK
authors.lastname: Bartsch
authors.forename: M
authors.initials: M
authors.lastname: Schober
authors.forename: D
authors.initials: D
authors.lastname: Librizzi
authors.forename: A
authors.initials: A
authors.lastname: Pfestroff
authors.forename: M
authors.initials: M
authors.lastname: Burbelko
authors.forename: R
authors.initials: R
authors.lastname: Moll
authors.forename: P
authors.initials: P
authors.lastname: Michl
authors.forename: T M
authors.initials: TM
authors.lastname: Gress
mesh_terms: D000293:Adolescent; D002291:Carcinoma, Papillary / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D010190:Pancreatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods; D055815:Young Adult