title: Pre-operative diagnosis of synchronous solid-pseudopapillary neoplasms of the pancreas.
abstract: We report the case of a 37-year-old woman with two synchronous solid-pseudopapillary neoplasms (SPNs) of the pancreas. The patient underwent abdominal echography as part of the screening for hepatitis C virus antibody positivity, and a pancreatic tail tumor was detected. She was referred to our hospital for further examination of the pancreatic tail tumor. There were two masses measuring 37 and 20 mm, in the pancreatic body and tail, respectively, which were slightly enhanced on abdominal computed tomography. On endoscopic ultrasonography (EUS), their surfaces were smooth, their margins were clear, anechoic spots were seen in the hypoechoic mass, and there were no lateral shadows. Magnetic resonance imaging showed a low- and high-intensity mass of the body and a low- and low-intensity mass of the tail on T1- and T2-weighted images, respectively. EUS-guided fine needle aspiration biopsy (EUS-FNA) suggested SPNs because the tumor cells showed an aberrant nuclear expression of β-catenin and loss of membranous staining of E-cadherin on immunohistochemical analysis. With a diagnosis of SPNs based on the EUS-FNA findings, a distal pancreatectomy was performed. On histopathologic examination of the resected specimen, the SPNs were arising synchronously.
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan. ayano0620@hotmail.co.jp.|Second Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan. ayano0620@hotmail.co.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sawaki
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Mizuno
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Hijioka
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kondo
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawai
authors.affiliation: Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Waki
authors.initials: W
authors.lastname: Hosoda
authors.affiliation: Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yatabe
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan. kyamao@aichi-cc.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
keywords: E-cadherin; Endoscopic ultrasonography (EUS); Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA); Solid-pseudopapillary neoplasm (SPN); β-Catenin