急性膵炎を契機に診断したsolid pseudopapillary neoplasmの一例

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  • A case of solid pseudopapillary neoplasm incidentally detected during a diagnostic workup of acute pancreatitis

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<p>A 14-year-old boy with epigastralgia was diagnosed with acute pancreatitis based on elevated levels of pancreatic amylase (225 IU/L) and lipase (677 IU/L), enlargement of the pancreatic tail, and increased density of the surrounding adipose tissue on computed tomography (CT) imaging. A 1.5-cm tumor was found that appeared as a low-absorption area on early-phase CT images, with increased intensity on late-phase images. Heavily T2-weighted magnetic resonance imaging (MRI) suggested that the tumor had triggered pancreatitis by displacing the main pancreatic duct. From these imaging findings, we suspected a solid pseudopapillary neoplasm (SPN). Fluid replacement and protease inhibitor therapy for pancreatitis were successful. Tumorectomy was performed 1 month after the onset of epigastralgia, and the diagnosis of SPN was confirmed based on the histological findings. Proactive use of diagnostic imaging is recommended for identifying the cause of acute pancreatitis. Because SPN is a possible cause, diagnostic images should be thoroughly examined for size, location, internal characteristics, capsule formation, calcification, relationship to the main pancreatic duct, and extent of invasion of the tumor, especially in pediatric cases.</p>

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