INTRODUCTION
SPNs are rare tumors comprising only 1 to 3% of all pancreatic tumors
[1]. There is a clear female preponderance (95.2% in a 29 case
series) of young age (from 24 to 39 years) [2]. SPNs were first
described by Frantz in 1959 as pancreatic papillary cystic tumors
[3] but the name SPN was finally defined in 2010 by WHO [4].
Usually it is a slowly growing tumor [2] incidentally found in
imaging exams, not associated with major symptoms [5], although it
can be detected as result of persistent unexplained upper abdominal pain
[6]. Despite its gradual growth, SPN has the potential to expand
significantly and generate compressive symptoms that manifest as
jaundice or a palpable abdominal mass [6]. SPN do not present
preferably in any specific part of the pancreas and size do not
correlate with malignancy index [2]. Tumors located in the distal
pancreas are more commonly larger [7]. SPNs are solitary [8] in
most cases and encapsulated [2, 9].
Gold standard treatment is surgical resection by enucleation, distal
pancreatectomy or pancreaticoduodenectomy [9] and definite diagnosis
is obtained by histological evaluation of the specimen [10]. Solid
sheets of tumor cells along with areas showing cells oriented around
fibrovascular cores and periodic acid Schiff positive hyaline globules
are typical histological findings [2, 11].
The majority of SPNs runs a benign course with an excellent prognosis
[12] but large series documented cases of malignancy based on
recurrence or metastasis in up to 22.8% cases [13, 14]. Due to its
rarity, its diagnosis can be difficult and should be considered in the
differential diagnosis of any solid or partly cystic pancreatic
neoplasm, especially in women under 35 years of age [2].
The authors present a case of a 52 years old patient with complaints of
recurrent upper abdominal pain that was diagnosed with SPN of the
uncinated pancreatic process.