Solid Pseudopapillary Tumour Of The Pancreas With Hepatic Metastasis: Spontaneous Regressionover 10-year Follow-up Period.
Yoon, H. J., & Lim, J. H. (2012). Solid pseudopapillary tumor of the pancreas with hepatic metastasis: spontaneous regression over 10-year follow-up period. Korean journal of radiology, 13(5), 648–651. https://doi.org/10.3348/kjr.2012.13.5.648
View Original Source →Abstract
A solid-pseudopapillary tumor (SPT) of the pancreas is known as a low grade malignant tumor with a good prognosis; therefore, surgical intervention is necessary. A 14-year-old boy presented with a large pancreatic SPT and three hepatic metastases. The patient and his family refused surgery. Two serial follow-up CT scans over a period of 13 years demonstrated almost complete disappearance of the pancreatic tumor and three hepatic metastases without relevant treatment. Although there have been a few reports of spontaneous healing of SPT, there has been no report regarding spontaneous disappearance of SPT and distant metastasis. Herein, we report on the spontaneous regression of a large SPT and the disappearance of three hepatic metastases.
Case Details
Disease Location
Pancreas with hepatic mets
Personal Characteristics
14-year-old boy
Clinical Characteristics
Presented with continuous upper abdominal pain after falling down. Physical examination revealed a soft, flat abdomen with no palpable mass or tenderness, and no enlargement of the superficial lymph nodes. Laboratory data upon admission showed no abnormalities in serum hormones levels and, tumour markers. Abdominal CT demonstrated an encapsulated mass measuring 11 x 10 cm in the left upper quadrant. The mass showed central low attenuated and peripheral high attenuating areas. After contrast administration, solid components showed heterogeneous enhancement due to irregular necrosis. The tail of the pancreas was not delineated, suggesting that the mass originated from the pancreatic tail. In the right hepatic lobe, there were three masses with maximum diameters of 6.0 cm, 5.3 cm, and 3.5 cm, respectively. Biopsy of the pancreatic mass revealed “a solid and cystic pseudopapillary neoplasm”
Remission Characteristics
Five years later, the patient visited the hospital in order to obtain a medical cerightificate. CT showed that the tumour had decreased in size from 11 to 4.5 cm and contained foci of calcification. The hepatic masses had almost disappeared, and only one 2-cm mass remained at the right hepatic dome. The last follow-up CT, which was performed 13 years later, showed that the size of the pancreatic mass was 3 cm and that the residual hepatic mass had completely disappeared.
Treatment & Mechanisms
Proposed Remission Mechanisms
Truly spontaneous
Clinical Treatment
Right portal vein embolization