Solid Pseudopapillary Neoplasm of the Pancreas with High-Grade Malignant Transformation Involving p16-RB Pathway Alterations

Case Reports in Surgery
Kodai TomiokaMasahiko Murakami

Abstract

Solid pseudopapillary neoplasm (SPN) of the pancreas has generally been regarded as a low-grade malignant tumour that preferentially develops in young women and can have a good prognosis with surgery. Among the few patients who have died from metastatic SPN are mostly those whose tumours harbour an undifferentiated component characterized by diffuse sheets of cells with increased nuclear atypia and proliferative index. We herein report a case of an aggressive, fatal, solid pseudopapillary neoplasm (SPN) of the pancreas in a 63-year-old woman complaining of epigastric pain. Despite having undergone surgical resection for a 10 cm pancreatic mass and multiple liver metastases, the patient later died due to uncontrollable metastases 36 months after the initial surgery. Histological examination showed that the tumour displayed unusual high-grade malignant features, showing diffuse sheets of cells with increased nuclear atypia and proliferative activity, along with conventional low-grade malignant features. The tumour was subsequently recognized as an SPN with foci of high-grade malignant transformation according to the 2010 World Health Organization classification. Immunohistochemical studies revealed that p16-RB pathway alterations...Continue Reading

References

Mar 10, 2009·American Journal of Surgery·Feng YangQuan Xing Ni
May 30, 2009·Journal of the American College of Surgeons·Sushanth ReddyChristopher L Wolfgang
Jul 1, 2014·Archives of Pathology & Laboratory Medicine·Bailey A ReindlAli D Jassim
Apr 30, 2017·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Susumu HijiokaNobumasa Mizuno
Oct 12, 2018·The Journal of Pathology·Eliana AmatoVincenzo Corbo

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Methods Mentioned

BETA
biopsy
pancreatectomy
dissection

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