An 83 year-old male with a solid pseudopapillary neoplasm of the pancreas

Abstract

An 83-year-old male was noted to have an elevated serum amylase level. Contrast enhanced CT scan revealed a heterogeneous mass in the head of the pancreas. The lesion was diagnosed as a solid pseudopapillary neoplasm (SPN) by EUS-FNA. We performed a subtotal stomach-preserving pancreaticoduodenectomy and lymph node dissection. Macroscopically, the tumor was 40×30×25mm, composed of blood, cysts and necrotic tissue. The histological findings included solid and partial pseudopapillary structures. Immunohistochemical staining was positive for beta-catenin and vimentin and partially positive for CD10. There was no staining for chromogranin or progesterone receptor. The final diagnosis was SPN. The patient is doing well and has no evidence of recurrence 2-years postoperatively. The number of male patients with SPN has been increasing recently, but there are no patients reported to date with SPN older than age 80. We believe that this patient is the oldest male yet reported with SPN.