title: Duodenum-preserving pancreatic head resection in solid pseudopapillary neoplasm-Report of a case.
abstract: BACKGROUND
  Solid pseudopapillary neoplasm (SPPN) was first characterized by Virginia Frantz in 1959. The duodenum-preserving pancreatic head resection (DPPHR) has been described as treatment for low-grade malignant tumors of the head of the pancreas including eight cases of SPPN.
  
  
  METHODS
  A 16-year-old white female patient presented with abdominal pain and dyspepsia. Computed tomography scan of abdomen showed a 10×9×10cm(3) lesion on the pancreatic head. After radiological diagnosis of SPPN the patient was submitted to DPPHR. Resection was achieved with clear margins. Immunohistochemical study demonstrated positivity for progesterone receptor, β-catenin, cytoplasmic paranuclear dot-like CD99, negativity for chromogranin and S100 protein and Ki 67 index of 1%.
  
  
  CONCLUSIONS
  A large encapsulated pancreatic mass with well-defined borders that contains areas of calcifications and intratumoral hemorrhage on CT scan in a young female is virtually diagnostic of an SPPN. A particular dot-like intracytoplasmic expression of CD99 appears to be highly unique for SPPN CONCLUSION: DPPHR should be considered in cases of SPPN in the pancreas head if there is no compromise with oncologic radicality.
authors.affiliation: Department of Surgery, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil. Electronic address: vivianresende.ufmg@gmail.com.
authors.forename: Vivian
authors.initials: V
authors.lastname: Resende
authors.affiliation: Department of Histopathology, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Paulo Hermane Rabelo
authors.initials: PH
authors.lastname: Azevedo
authors.affiliation: Department of Surgery, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Leonardo do Prado
authors.initials: Ldo P
authors.lastname: Lima
authors.affiliation: Department of Surgery, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: André Rossetti
authors.initials: AR
authors.lastname: Portela
authors.affiliation: Department of Surgery, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Marcelo Dias
authors.initials: MD
authors.lastname: Sanches
authors.affiliation: Department of Histopathology, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Moisés Salgado
authors.initials: MS
authors.lastname: Pedrosa
keywords: Duodenum-preserving pancreatectomy; Immunohistochemistry; Solid pseudopapillary neoplasm
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