J Liver Cancer.  2018 Sep;18(2):168-174. 10.17998/jlc.18.2.168.

Multiple Hepatic Metastasis and Lymphatic Metastasis of Solid Pseudopapillary Neoplasm of Pancreas

• Kim YG
• Kim BI
• Kim SK
• Kim HS
• Kim HJ
• Cho YK
• Jeon YG

• KMID: 2422631
• DOI: http://doi.org/10.17998/jlc.18.2.168

Abstract

Solid pseudo-papillary neoplasm (SPN) of pancreas is a rare epithelial neoplasm of pancreas with a low malignant potential, occurs most commonly in young females. Here, we report a rare case of woman who has severe hepatomegaly due to multiple hepatic metastases of SPN of pancreas. At the time of diagnosis, a SPN was detected at only pancreas and there was no evidence of metastasis. So, she received subtotal pancreatectomy and total splenectomy. After 2 years of follow up, multiple small hepatic metastases were presented. In spite of three times of radiofrequency ablation, the burden of hepatic metastasis has increased continuously and multiple intra-abdominal lymph nodes metastases were detected, and ascites and peripheral edema occurred. However, because of benign feature of SPN and extremely rare incidence of recurrence and metastasis, there is no specific treatment guideline for metastatic SPN. Through multidisciplinary care service, we planned to do radiotherapy followed by a transarterial chemoembolization (TACE). But the patient could not have a scheduled radiation therapy due to deterioration of liver function. So changing the strategy of treatment, followed by TACEs were done alone. Although the size of SPN is not reduced, the extent of SPN and complication of SPN (ascites, peripheral edema, abdominal pain and so on) are being controlled.

Keyword

Solid pseudo-papillary neoplasm; Hepatic metastasis, TACE

MeSH Terms

Abdominal Pain
Ascites
Catheter Ablation
Diagnosis
Edema
Female
Follow-Up Studies
Hepatomegaly
Humans
Incidence
Liver
Lymph Nodes
Lymphatic Metastasis*
Neoplasm Metastasis*
Neoplasms, Glandular and Epithelial
Pancreas*
Pancreatectomy
Radiotherapy
Recurrence
Splenectomy