A case of laparoscopic distal pancreatectomy for solid-pseudopapillary neoplasm of the pancreas in which endoscopic ultrasound-guided fine needle aspiration was useful for preoperative diagnosis and decision making for operative strategy Keiko KAMEI 1 , Ippei MATSUMOTO 1 , Takaaki MURASE 1 , Hajime ISHIKAWA 1 , Takuya NAKAI 1 , Yoshifumi TAKEYAMA 1 1Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kindai University Faculty of Medicine Keyword: 腹腔鏡下尾側膵切除術 , 膵solid-pseudopapillary neoplasm , 超音波内視鏡下穿刺吸引法 pp.307-313
Published Date 2016/5/15
DOI https://doi.org/10.11477/mf.4426200264
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Since solid-pseudopapillary neoplasm of pancreas(SPN) is a low grade maligant neoplasm and mostly occurrs in young woman, it is a good candidate for laparoscopic distal pancreatectomy (LDP). The patient was 37-year-old woman. A contrast enhanced CT scan revealed a solid tumor with the size of 35mm in the body of the pancreas. An endoscopic ultrasound fine needle aspiration(EUS-FNA) was conducted because differential diagnosis was dificult to make with imaging study alone from other malignant pancreatic tumors including neuroendocrine tumor and acinar cell carcinoma, which may require radical open surgery. Our histopathological findings derived from the samples taken during EUS-FNA included the presence of cells with round nuclei that showed pseudopapillary growth. Immunoreactivity for β-catenin was found in the cytoplasm and nuclei of the tumor. EUS-FNA played the definitive role in making preoperative diagnosis of SPN. She underwent LDP. EUS-FNA was useful for preoperative diagnosis and decision making for the operative strategy in this patient, because the tumor presented with an atypical feature without cystic compartment.

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