A Case Report of Solid Cystic Tumor of the Pancreas

Shouichi Uchiyama, Masashi Takahashi, Masao Yano, Tasuku Shouji*

Department of Surgery, Yugawara Kosei-nenkin Hospital *Second Department of Surgery, Nippon Medical School

A case of solid and cystic tumor of the pancreas is reported. The patient was an l8-year-old woman with the chief complaints of epigastric and back pain. She was admitted to our hospital, because endoscopy revealed compression of the stomach. The results of laboratory tests were unremarkable. A solid cystic tumor of the pancreatic body was strongly suspected on the basis of ultrasonography, abdominal CT and MR imaging. At laparotomy, the tumor (9×7×7 cm) was well encapsulated and arose from the body of the pancreas. Distal pancreatectomy was performed. Gross pathological examination showed that the tumor was circumscribed by a fibrous capsule and contained areas of severe hemorrhagic necrosis. Microscopically, the tumor cells showed solid proliferation in a pseudopapillary pattern. Collections of xanthoma cells and cholesterol granulomas were observed around it. Immunohistochemical examination for alpha-l-antitrypsin was positive, and electron microscopy revealed numerous zymogen-like granules in the pancreas. The patient has been followed up for 6 months with no evidence of recurrence.

Key words
solid cystic tumor

Reprint requests
Shouichi Uchiyama Department of Surgery, Tokyu Hospital
1-45-6 Kitasenzoku, Oota-ku, Tokyo, 145 JAPAN

Accepted
June 17, 1992

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