Authors
Richi Nakatake, Hiroaki Kitade, Hidesuke Yanagida, Morihiko Ishizaki, Tetsuya Okuyama, Yoshiko Uemura, Sohei Satoi
Published in
Clinical journal of gastroenterology. Jun 15, 2026. Epub Jun 15, 2026.
Abstract
Solid pseudopapillary neoplasms (SPNs) are rare pancreatic tumors with low malignant potential. Although SPNs often grow slowly and may reach a large size before detection, tumors > 20 cm in diameter are extremely rare.
A 45-year-old asymptomatic woman was incidentally found to have a large abdominal mass during a routine health examination. Serum CEA and CA19-9 levels were within normal limits. Contrast-enhanced CT revealed a well-encapsulated cystic mass measuring approximately 20 cm, with heterogeneous internal density and focal mural thickening. MRI demonstrated a predominantly cystic lesion with high signal intensity on T2-weighted images and restricted diffusion in the solid components. Complete surgical resection was performed, with an operative time of 4 h 9 min and blood loss of 42 mL. Pathological examination confirmed a 22 × 22-cm SPN with typical histological and immunohistochemical features. Postoperative portal vein thrombosis was successfully treated with anticoagulation therapy. The patient was discharged on postoperative day 17 and remains recurrence-free 5 years after surgery.
This case demonstrates that even extremely large SPNs can be safely resected with excellent long-term outcomes, and tumor size alone should not be considered an indicator of aggressive biological behavior.
PMID:
42295568
Bibliographic data and abstract were imported from PubMed on 15 Jun 2026.
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