Recurrent Solid Pseudopapillary Tumor of the Pancreas with Direct Extension into Gastric Mucosa: A Case Report with Consideration for Patient Management

Main Article Content

Vinaya Rajahraman, MD James Lindberg, MD R. Leslie Shelton, MD Tasneem Ali, MD Neil Marya, MD Lacey McIntosh, DO Elisa Franquet-Elia Larry Zheng, MD Tasneem Lalani, MD Alan Goldstein, MD Brian Midkiff, MD Andrew Fischer, MD Salwa Khedr, MD Yansong Geng, MS Linda Ding Maryann Bishop-Jodoin, MEd Thomas J. FitzGerald, MD

Abstract

A 77-year-old woman with a history of a pancreatic mass underwent distal pancreatectomy with splenectomy in 2007 in Brazil. After presentation in September 2021 with melena and coffee-ground emesis, she received a computed tomography scan and esophagogastroduodenoscopy revealing a prominent mass lesion including the pancreas at the level of the resection margin with extension into the gastric fundus. Subsequent endoscopic ultrasound and fine needle aspiration biopsy confirmed the lesions as recurrent solid pseudopapillary tumor with direct extension to the gastric fundus. The treatment strategy included chemotherapy, intensity-modulated radiation therapy, and surgery. In this case report, we discuss strategic applications of tri-modality therapy, including surgical removal of residual gastric disease.

Article Details

How to Cite
RAJAHRAMAN, Vinaya et al. Recurrent Solid Pseudopapillary Tumor of the Pancreas with Direct Extension into Gastric Mucosa: A Case Report with Consideration for Patient Management. Medical Research Archives, [S.l.], v. 12, n. 8, sep. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5515>. Date accessed: 07 oct. 2024.
Section
Case Reports

References

1. Reddy S, Cameron JL, Scudiere J, et al. Surgical management of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi Tumors): a large single-institutional series. J Am Coll Surg. 2009;208(5):950-957. doi:10.1016/j.jamcollsurg.2009.01.044
2. Younan G. Pancreas solid tumors. Surg Clin North Am. 2020;100(3): 565-580. doi: 10.1016/j.suc.2020.02.008
3. Karakas S, Dirican A, Soyer V, Koç S, Ersan V, Ates M. A pancreatic pseudopapillary tumor enucleated curatively. Int J Surg Case Rep. 2015;10:118-120. doi:10.1016/j.ijscr.2015.03.040
4. Lubezky N, Papoulas M, Lessing Y, et al. Solid pseudopapillary neoplasm of the pancreas: management and long-term outcome. Eur J Surg Oncol. 2017;43(6): 1056-1060. doi:10.1016/j.ejso.2017.02.001
5. Flores RL, Rossi R, Castiblanco A, Gallardo A, Schiappacasse G. Solid bifocal pseudopapillary neoplasm of the pancreas: a case report. Int J Surg Case Rep. 2021;84: 106131. doi:10.1016/j.ijscr.2021.106131
6. Tanoue K, Mataki Y, Kurahara H, et al. Multidisciplinary treatment of advanced or recurrent solid pseudopapillary neoplasm of the pancreas: three case reports. Surg Case Rep. 2022;8(1):7. doi:10.1186/s40792-022-01358-0
7. Kang CM, Kim KS, Choi JS, Kim H, Lee WJ, Kim BR. Solid pseudopapillary tumor of the pancreas suggesting malignant potential. Pancreas. 2006;32(3): 276-280. doi:10.1097/01.mpa.0000202956.41106.8a
8. Eder F, Schulz HU, Röcken C, Lippert H. Solid-pseudopapillary tumor of the pancreatic tail. World J Gastroenterol. 2005;11(26):4117-4119. doi:10.3748/wjg.v11.i26.4117
9. Stefanova N, Kalinov T, Kolev N, Kalchev E. Frantz tumor: a case report of solid pseudopapillary tumor of pancreas. Cureus. 2023;15(7):e41698. doi:10.7759/cureus.41698
10. Law JK, Ahmed A, Singh VK, et al. A systematic review of solid-pseudopapillary neoplasms: are these rare lesions? Pancreas. 2014;43(3):331-337. doi:10.1097/MPA.0000000000000061
11. Perez A, Arcilla C, Fontanilla MRK, Berberabe AE. Resection of a recurrent solid pseudopapillary neoplasm of the pancreas after duodenal sparing pancreaticoduodenectomy: a case report. Int J Surg Case Rep. 2021;88: 106526. doi:10.1016/j.ijscr.2021.106526
12. Blastik M, Plavecz E, Zalatnai A. Pancreatic carcinomas in a 60-year, institute-based autopsy material with special emphasis of metastatic pattern. Pancreas. 2011;40(3): 478-480. doi:10.1097/MPA.0b013e318205e332
13. Umezaki N, Hashimoto D, Nakagawa S, et al. Cystic gastric metastasis from pancreatic cancer. Surg Case Rep. 2018;4(1):31. doi:10.1186/s40792-018-0443-2
14. Yamada Y, Sasaki T, Takeda T, et al. Multiple gastric metastases after distal pancreatectomy for pancreatic cancer. Intern Med. 2022;61(18):2741-2746. doi:10.2169/internalmedicine.8848-21
15. Oda, Kondo H, Yamao T, et al. Metastatic tumors to the stomach: analysis of 54 patients diagnosed at endoscopy and 347 autopsy cases. Endoscopy. 2001;33(6):507-510. doi:10.1055/s-2001-14960
16. Yang J, Yuan Y, Zhang S, Lv Y. Gastric metastasis from pancreatic cancer characterized by mucosal erosion: a case report and literature review. Journal of International Medical Research. 2021;49(4). doi:10.1177/03000605211003759
17. Sasajima J, Okamoto K, Taniguchi M. Hematogenous gastric metastasis of pancreatic cancer. Case Rep Gastroenterol. 2016;10(1):75-80. doi:10.1159/000444249
18. Feczko PJ, Collins DD, Mezwa DG. Metastatic disease involving the gastrointestinal tract. Radiol Clin North Am. 1993;31(6):1359-1373. doi:10.1016/S0033-8389(22)00325-6
19. Gao H, Gao Y, Yin L, et al. Risk factors of the recurrences of pancreatic solid pseudopapillary tumors: a systematic review and meta-analysis. J Cancer. 2018;9(11):1905-1914. doi:10.7150/jca.24491
20. Strauss JF, Hirsch VJ, Rubey CN, Pollock M. Resection of a solid and papillary epithelial neoplasm of the pancreas following treatment with cis‐platinum and 5‐fluorouracil: a case report. Med Pediatr Oncol. 1993;21(5):365-367. doi:10.1002/mpo.2950210511
21. Sibio S, Di Carlo S. Current highlights on solid pseudopapillary neoplasm of the pancreas. World J Hepatol. 2022;14(1):300-303. doi:10.4254/wjh.v14.i1.300
22. Zauls JA, Dragun AE, Sharma AK. Intensity-modulated radiation therapy for unresectable solid pseudopapillary tumor of the pancreas. Am J Clin Oncol. 2006;29(6):639-640. doi:10.1097/01.coc.0000190457.43060.fd
23. Zheng Y, Gao W, Spratt DE, Sun Y, Xing L. Management of gastrointestinal perforation related to radiation. Int J Clin Oncol. 2020;25(6):1010-1015. doi:10.1007/s10147-020-01662-5
24. Meyer JE, Kharofa J. The role of dose escalation in pancreatic cancer: go big or go home? Int J Radiat Oncol Biol Phys. 2023;115(2):395-397. doi: 10.1016/j.ijrobp.2022.09.050
25. Lee D, Komatsu S, Terashima K, et al. Surgical spacer placement for proton radiotherapy in locally advanced pancreatic body and tail cancers: initial clinical results. Radiat Oncol. 2021;16(1):3. doi: 10.1186/s13014-020-01731-z
26. Thomas TO. Hasan S, Small W Jr, et al. The tolerance of gastrointestinal organs to stereotactic body radiation therapy: what do we know so far? J Gastrointest Oncol. 2014;5(3):236-246. doi:10.3978/j.issn.2078-6891.2014.024
27. Furman MJ, Whalen GF, Shah SA, Kadish SP. Gastric perforation following stereotactic body radiation therapy of hepatic metastasis from colon cancer. Pract Radiat Oncol. 2013;3(1):40-44. doi:10.1016/j.prro.2012.03.005