Distal
Pancreatectomy with Spleenectomy for Solid Pseudopapillary Tumor of Pancreas
Patient
Information
Age 19 year Sex
F Date of Procedure 11- 03 –
2013
Brief Case
History
Patient was
asymptomatic 4 months back. She developed upper abdominal pain. The pain was
severe intermittent and radiating to back. Pain was not associated with nausea,
vomiting, jaundice, abnormal bowel habit. She was not having anorexia or weight
loss. Pain was not associated with food habit. It was relieved by taking
medicines. On examination she was vitally stable, on per abdomen examination
upper abdominal tenderness mainly in epigastric and umbilical regions.
Suspected
Cause / diagnosis based on patient’s history / examination
On the basis
of history and examination she could be having either acid peptic disease or
disease related to pancreatic origin.
Diagnostic
Tests
Her routine
blood tests were normal. Her ultrasound was suggestive of solid mass arising
from the pancreatic tail extending to the splenic hilum. She was asked for CECT
abdomen. On CECT there was a solid tumour of 7 x 7 x 8 cm in size arising from
body and tail of pancreas, displacing the superior mesenteric artery and vein. Splenic
artery was involved in the tumour superiorly. It was not attached to stomach.
Surgery
Laparotomy
was performed by “L” shape incision. On dividing the gastrocolic ligament there
was a large tumour arising from pancreas and reaching up to the splenic hilum. Splenic
artery was identified near to its origin and divided. Spleen was mobilised and
gastrocolic, phrenosplenic, splenocolic ligaments were divided. Pancreas was
mobilised from inferior surface and rotated to other site. Tumour was
transacted just left of the superior mesenteric vein and removed with the
spleen. Pancreatic stump was closed with prolene 4 – 0 in two layers. First
duct was secured and then the stump closed separately.
Comments and
Conclusion
Histopathology
report turned out to be solid pseudopapillary tumour of pancreas. It is one of
the rare tumour of pancreas, mainly seen in young female with low risk of
metastasis. Surgery is the only modality of treatment with >95 % 5 year
survival rate.
 |
Large Solid Mass Arising from Body and Tail of Pancreas
|
 |
| Large Pancreatic Body and Tail Mass |
 |
| Pseudopapillary Tumor of Pancreas |
 |
| Pancreatic Stump Closure |
 |
| Specimen Of Distal Pancreatectomy |
