Abstract
A 49-year-old woman visited our hospital because upon screening, PET imaging showed increased fluorodeoxyglucose uptake in the pancreas tail. CT scan and MR imaging revealed a 1cm solid tumor mass in the pancreas tail. No cysts or calcifications were identified. Serum levels of tumor markers and endocrine hormones were within normal levels. We performed distal pancreatectomy because of suspicious pancreatic cancer. On histological examination, we identified small and uniform tumor cells with eosinophilic cytoplasm having a solid growth pattern. Immunohistochemical staining showed that tumor cells were positive for α1-antitrypsin, CD10, NSE and CD56, and negative for synaptophysin and Chromogranin A. We diagnosed this case as a solid pseudopapillary neoplasm (SPN). A small SPN having no calcification or cyst is difficult to distinguish from pancreatic cancer. Since small SPN can have a high uptake of FDG, PET imaging is not useful for the differential diagnosis from pancreatic cancer.
