Korean J Radiol.  2012 Oct;13(5):648-651. 10.3348/kjr.2012.13.5.648.

Solid Pseudopapillary Tumor of the Pancreas with Hepatic Metastasis: Spontaneous Regression Over 10-Year Follow-Up Period

• Yoon HJ
• Lim JH

• KMID: 1392946
• DOI: http://doi.org/10.3348/kjr.2012.13.5.648

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.

Keyword

Solid-pseudopapillary neoplasm; Hepatic metastasis; Pancreas; Natural course; Computed tomography

MeSH Terms

Adolescent
Carcinoma, Papillary/radiography/*secondary
Humans
Liver Neoplasms/radiography/*secondary
Male
Pancreatic Neoplasms/*pathology/radiography
Remission, Spontaneous
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Serial CT images of 14-year-old with continous upper abdominal pain after falling down. A, B. Contrast-enhanced CT images demonstrate 11 × 10 cm encapsulated mass in left upper quadrant showing slightly heterogeneous enhancement. Mass comes in direct contact with anteriorly displaced pancreatic body (arrowhead). Note marked dilatation of pericapsular veins (arrows). Two hepatic metastatic tumors, measuring 6.0 cm and 3.5 cm, respectively, are observed in right hepatic lobe. Another tumor, measuring 5.3 cm was observed in right hepatic lobe on another CT image (not shown). C, D. Contrast-enhanced CT images 5 years later show that primary tumor has decreased to 4.5 cm in longest diameter (arrow), and contains several small calcific foci. Small residual mass, measuring 2 cm is observed at right hepatic dome. E, F. CT image 13 years later shows further decrease in pancreatic mass to 3 cm (arrow), with more prominent calcification. Small mass at right hepatic dome has completely disappeared. SMV = superior mesenteric vein

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