TUMOR SÓLIDO PSEUDOPAPILAR DE PÁNCREAS EN UNA MUJER DE 20 AÑOS DE EDAD: REPORTE DE UN CASO

Carlos Espino; Leidy Vázquez A.

Submitted March 28, 2025

Published 2026-04-06

Artículos de Investigación

Vol. 21 No. 2 (2008): Revista Médico Científica

PSEUDOPAPILLARY SOLID TUMOR OF PANCREAS IN A WOMAN OF 20 YEARS OLD: A CASE REPORT

Carlos Espino⁺⁻
Leidy Vázquez A.⁺⁻

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Published: 2026-04-06

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Abstract

A solid pseudopapillary tumor of the pancreas is a non-frequent neoplasia, considered to be a low-grade malignant tumor of unknown etiology. It represents approximately 5 % of all pancreatic cyst tumors and 1-2 % of all exocrine pancreatic tumors. These tumors have a greater tendency in female and the peak incidence rates are observed in the third decade of life.

We present the case of a 20 year-old female patient who was admitted to the General surgery service of Hospital Santo Tomás,
with a 5 years history of having an abdominal non-tender mass in the right hypochondrium. The mass has had a progressive growth
and is now associated with postprandial gastric fullness, with no other associated symptoms like fever, nauseas, melena or weight loss. The palpation of the abdomen revealed the presence of a movable mass, with a hard consistency, and an approximate size of 8 x 5 cms, located in the right hypochondrium. The results of tumoral markers CA 19-9, CA-125, alpha fetoprotein and carcinoembryonic antigen were not elevated. The abdominal computerized tomography reported the presence of a solid cystic pancreatic head tumor. With a preoperative diagnosis of pancreatic head tumor, its resection was performed with pancreatoduodenectomy (Whipple's procedure). The histological analysis of the surgical specimen confirmed the presence of a solid
pseudopapillary tumor of the pancreas with negative surgical margins and without vascular infiltration.

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References

Klimstra DS, Wenig BM, Heffess CS. Solid-pseudopapillary tumor of the pancreas: A tipically cystic carcinoma of low malignant potential. Semin Diagn Pathol 2000; 17:66-80.
Casadei R, Santini D, Calculli L, Pezzilli R, Zanini N, Minni F. Pancreatic solid-cyst papillary tumor: clinical features, imaging findings and operative managment. JOP, 2006; 7:137-44.
Santero Ramirez MP, Gonzalvo E, Martinez A, Del Rio Marco FJ. Tumor papilar solido quistico de pancreas. Tres formas distintas de presentacion. Rev Esp Enf Dig 2004; 96:285-6
Kasem A, Ali Z, Ellul J. Papillary cystic and solid tumor of the pancreas: Report of case and literature review. World J Surg Oncol 2005; 3:62.
Martin RC, Klimstra DS, Brennan MF, Conlon KC. Solid- pseudopapillary tumor of the pancreas: A surgical enigma? Ann Surg Oncol 2002; 9:35-40.
Abraham S, Klimstra D, Wilentz R, Yeo C, Conlon K, Brennan M, et al. Solid-pseudopapillary tumors of the pancreas are genetically distinct from pancreatic ductal adenocarcinoma and almost always harbour B-catenin mutations. Am J Pathol 2002, 160:1361-9.
Tanaka Y, Kato K, Notohara K, Hojo H, Ijiri R, Mayake T et al. Frequent beta catenin mutation and cytoplasmic/nuclear accumulation in pancreatic solid-pseudopapillary neoplasm. Cancer Res 2001; 61:8401-4.
Costas SRP, Henriques AC, Godinho CA, Miotto MJ, Costas MC, Horta SH, et al. Pancreatic solid-cystic papillary tumor: clinical aspects, radiological findings and surgical treatment in a series of five patients. Einstein 2007; 5:161-5.
Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English Literature. J Am Coll Surg 2005; 6:965-72.
Cerdan, R, Barranco, JI, Cantin, S, Bernal J, Serrablo A, Esarte JM. Tumor de Frantz. Presentacion de un caso. Rev Chil Cir 2007; 59(2):145-9.
Schwartz S, Shires G, Spencer F, Daly J, Fischer J, Galloway A. Principles of surgery. 7th ed. USA: McGraw-Hill; 1999.
Towsend C, Beauchamp R, Evers BM, Mattox K. Sabiston Textbook of Surgery. 17th ed. St. Louis: WB Saunders Co; 2004.
Kloppel G, Kosmahl M. Cystic lesions and neoplasms of the pancreas.The features are becoming clearer. Pancreatology 2001;1:648-55.
Targarona J, Paggi L, Garatea R, Romero C, Rosamedina J, Lora A y col. Tumores solidos pseudopapilares de pancreas. Reporte de 7 casos y revision de la literatura. Rev Gastroenterol Perú 2007; 27:185-90.
Tilger A. Beitrag zur pathologischen Anatomie und Aetiologie der påncreas-cystern. Arch Pathol Anat Physiol Klin Med 1994; 137:348-75
Frantz VK. Tumors of the pancreas. Atlas of Tumor Pathology. Washington DC: Armed Forces Institute of Pathology; 1959: 32-3
Martinez-Peñuela A, Echeveste J, Toledo G, Lozano M, Sola I. Tumor solido pseduopapilar de pancreas simulador de pseudoquiste pancreatico: descripción de un caso y revisión de la literatura. Rev Esp Patol 2006; 39:184-9.
Tang LH, Haydin H, Brennan MF, Klimstra DS. Clinically agressive solid pseudopapillary tumors of the pancreas. A report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases. Am J Surg Pathol 2005; 29: 512-9.
Solcia E, Capella C, Kloppel G. Tumors of the pancreas. In Atlas of tumor pathology. 3rd ed. Washington, DC: Armed Forces Institute of Pathology; 1997. p. 120-44.
Lee WJ, Park YT, Choi JS, Chi HS, Kim BR: Solid and papillary neoplasm of the pancreas. Yonsei Med J 1996, 37:131-41.
Kosmahl M, Seada LS, Janig U, Harms D, Kloppel G. Solid pseudopapillary tumor of the pancreas: its origin revisited. Virchows Arch 2000; 436: 473-80.
Eder H, Rocken C, Lippert H. Solid pseudopapillary tumor of the pancreatic tail. World J Gastroenterol 2005; 11:4117-9.
Cao D, Maitra A, Saavedra JA, Klimstra DS, Adsay NV, Hruban RH. Expression of novel markers of pancreatic ductal adenocarcinoma in pancreatic nonductal neoplasms: additional evidence of different genetic pathways. Mod Pathol 2005; 18: 752-61.
Zinner MJ, Shurbaji MS, Cameron JL. Solid and papillary epithelial neoplasm of the pancreas. Surgery 1990;108:475-80.
Spinelli KS, Fromwiller TE, Daniel RA, Kiely JM, Nakeeb A et al. Cystic pancreatic neoplasms. Ann Surg. 2004;239(5):651-9.
Telford GL, Ormsbee HS 3rd, Mason GR. Pancreaticogastrostomy improved by a pancreatic duct-to-gastric mucosa anastomosis. Curr Surg 1980; 37: 140-2.
Diener M, Knnaebel HP, Heukaufer C, Antes G, Buchler M, Seiler C. A Systematic Review and Meta-analysis of Pylorus-preserving Versus Classical Pancreaticoduodenectomy for Surgical Treatment of Periampullary and Pancreatic Carcinoma. Ann Surg 2007; 245(2):187-200.
TredeM, Chir B, Schwall G. The complications of pancreatectomy. Ann Surg 1988; 207: 39-47.
Strasberg SM, Drebin JA, Soper NJ. Evolution and current status of the Whipple procedure: an update for gastroenterologists. Gastroenterology 1997; 113: 983-7.
Sikora SS, Posner MC. Management of the pancreatic stump following pancreaticoduodenectomy. Br J Surg 1995; 82: 1590
Waugh JM, Clagett OT: Resection of the duodenum and the head of the pancreas for carcinoma. Surgery 1946; 20: 224-6.
Waugh E. Pancreatogastroanastomosis en pancreatoduode nectomia. Una alternativa segura de anastomosis al muñon pancreatico. Rev Chil Cir 2002; 54:59-64.
Yeo CJ, Cameron JL, Maher MM et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg 1995; 222: 580-5.

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[1] Klimstra DS, Wenig BM, Heffess CS. Solid-pseudopapillary tumor of the pancreas: A tipically cystic carcinoma of low malignant potential. Semin Diagn Pathol 2000; 17:66-80.

[2] Casadei R, Santini D, Calculli L, Pezzilli R, Zanini N, Minni F. Pancreatic solid-cyst papillary tumor: clinical features, imaging findings and operative managment. JOP, 2006; 7:137-44.

[3] Santero Ramirez MP, Gonzalvo E, Martinez A, Del Rio Marco FJ. Tumor papilar solido quistico de pancreas. Tres formas distintas de presentacion. Rev Esp Enf Dig 2004; 96:285-6

[4] Kasem A, Ali Z, Ellul J. Papillary cystic and solid tumor of the pancreas: Report of case and literature review. World J Surg Oncol 2005; 3:62.

[5] Martin RC, Klimstra DS, Brennan MF, Conlon KC. Solid- pseudopapillary tumor of the pancreas: A surgical enigma? Ann Surg Oncol 2002; 9:35-40.

[6] Abraham S, Klimstra D, Wilentz R, Yeo C, Conlon K, Brennan M, et al. Solid-pseudopapillary tumors of the pancreas are genetically distinct from pancreatic ductal adenocarcinoma and almost always harbour B-catenin mutations. Am J Pathol 2002, 160:1361-9.

[7] Tanaka Y, Kato K, Notohara K, Hojo H, Ijiri R, Mayake T et al. Frequent beta catenin mutation and cytoplasmic/nuclear accumulation in pancreatic solid-pseudopapillary neoplasm. Cancer Res 2001; 61:8401-4.

[8] Costas SRP, Henriques AC, Godinho CA, Miotto MJ, Costas MC, Horta SH, et al. Pancreatic solid-cystic papillary tumor: clinical aspects, radiological findings and surgical treatment in a series of five patients. Einstein 2007; 5:161-5.

[9] Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English Literature. J Am Coll Surg 2005; 6:965-72.

[10] Cerdan, R, Barranco, JI, Cantin, S, Bernal J, Serrablo A, Esarte JM. Tumor de Frantz. Presentacion de un caso. Rev Chil Cir 2007; 59(2):145-9.

[11] Schwartz S, Shires G, Spencer F, Daly J, Fischer J, Galloway A. Principles of surgery. 7th ed. USA: McGraw-Hill; 1999.

[12] Towsend C, Beauchamp R, Evers BM, Mattox K. Sabiston Textbook of Surgery. 17th ed. St. Louis: WB Saunders Co; 2004.

[13] Kloppel G, Kosmahl M. Cystic lesions and neoplasms of the pancreas.The features are becoming clearer. Pancreatology 2001;1:648-55.

[14] Targarona J, Paggi L, Garatea R, Romero C, Rosamedina J, Lora A y col. Tumores solidos pseudopapilares de pancreas. Reporte de 7 casos y revision de la literatura. Rev Gastroenterol Perú 2007; 27:185-90.

[15] Tilger A. Beitrag zur pathologischen Anatomie und Aetiologie der påncreas-cystern. Arch Pathol Anat Physiol Klin Med 1994; 137:348-75

[16] Frantz VK. Tumors of the pancreas. Atlas of Tumor Pathology. Washington DC: Armed Forces Institute of Pathology; 1959: 32-3

[17] Martinez-Peñuela A, Echeveste J, Toledo G, Lozano M, Sola I. Tumor solido pseduopapilar de pancreas simulador de pseudoquiste pancreatico: descripción de un caso y revisión de la literatura. Rev Esp Patol 2006; 39:184-9.

[18] Tang LH, Haydin H, Brennan MF, Klimstra DS. Clinically agressive solid pseudopapillary tumors of the pancreas. A report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases. Am J Surg Pathol 2005; 29: 512-9.

[19] Solcia E, Capella C, Kloppel G. Tumors of the pancreas. In Atlas of tumor pathology. 3rd ed. Washington, DC: Armed Forces Institute of Pathology; 1997. p. 120-44.

[20] Lee WJ, Park YT, Choi JS, Chi HS, Kim BR: Solid and papillary neoplasm of the pancreas. Yonsei Med J 1996, 37:131-41.

[21] Kosmahl M, Seada LS, Janig U, Harms D, Kloppel G. Solid pseudopapillary tumor of the pancreas: its origin revisited. Virchows Arch 2000; 436: 473-80.

[22] Eder H, Rocken C, Lippert H. Solid pseudopapillary tumor of the pancreatic tail. World J Gastroenterol 2005; 11:4117-9.

[23] Cao D, Maitra A, Saavedra JA, Klimstra DS, Adsay NV, Hruban RH. Expression of novel markers of pancreatic ductal adenocarcinoma in pancreatic nonductal neoplasms: additional evidence of different genetic pathways. Mod Pathol 2005; 18: 752-61.

[24] Zinner MJ, Shurbaji MS, Cameron JL. Solid and papillary epithelial neoplasm of the pancreas. Surgery 1990;108:475-80.

[25] Spinelli KS, Fromwiller TE, Daniel RA, Kiely JM, Nakeeb A et al. Cystic pancreatic neoplasms. Ann Surg. 2004;239(5):651-9.

[26] Telford GL, Ormsbee HS 3rd, Mason GR. Pancreaticogastrostomy improved by a pancreatic duct-to-gastric mucosa anastomosis. Curr Surg 1980; 37: 140-2.

[27] Diener M, Knnaebel HP, Heukaufer C, Antes G, Buchler M, Seiler C. A Systematic Review and Meta-analysis of Pylorus-preserving Versus Classical Pancreaticoduodenectomy for Surgical Treatment of Periampullary and Pancreatic Carcinoma. Ann Surg 2007; 245(2):187-200.

[28] TredeM, Chir B, Schwall G. The complications of pancreatectomy. Ann Surg 1988; 207: 39-47.

[29] Strasberg SM, Drebin JA, Soper NJ. Evolution and current status of the Whipple procedure: an update for gastroenterologists. Gastroenterology 1997; 113: 983-7.

[30] Sikora SS, Posner MC. Management of the pancreatic stump following pancreaticoduodenectomy. Br J Surg 1995; 82: 1590

[31] Waugh JM, Clagett OT: Resection of the duodenum and the head of the pancreas for carcinoma. Surgery 1946; 20: 224-6.

[32] Waugh E. Pancreatogastroanastomosis en pancreatoduode nectomia. Una alternativa segura de anastomosis al muñon pancreatico. Rev Chil Cir 2002; 54:59-64.

[33] Yeo CJ, Cameron JL, Maher MM et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg 1995; 222: 580-5.

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