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Synchronous solid pseudopapillary neoplasm of the pancreas with intrahepatic cholangiocarcinoma in a young male patient: An unusual deadly occurrence.

Authors:
Moshawa Calvin Khaba Nkomba Christopher Kalenga Ramatsimele Rebothile Phetla Victor Mngomezulu Moses Aschenaz Balabyeki

Int J Surg Case Rep 2021 Mar 26;82:105841. Epub 2021 Mar 26.

Department of General Surgery, Hepatopancreatobiliary Unit, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, South Africa.

Introduction And Importance: Solid pseudopapillary neoplasm of the pancreas (SPN) is a tumour with low malignant potential, albeit with good prognosis. Intrahepatic cholangiocarcinoma (iCCA) is a malignant and aggressive tumour with poor prognosis.

Clinical Presentation: We report a case of a 38 years old African male patient with abdominal pain for 5 years that worsened in the preceding 5 months. Radiology showed pancreatic and liver lesions which were thought to be malignant and benign, respectively. However, intra-operative and histopathological assessment confirmed SPN and iCCA which were contrary to radiological findings. Whilst surgery was uneventful, the patient died after 15 days.

Clinical Discussion: Whilst SPN is commonly seen in young females, it is rare in males and has been associated with aggressive behaviour. The prognosis is good, albeit the presence of metastasis. iCCA is rare in younger population notwithstanding the presence of risk factor. Combination of iCCA and SPT has not been described. Both these tumours do not share risk factors, pathogenesis or molecular alterations.

Conclusion: The concomitant occurrence of these two pathologies in young male patient is unusual and preoperative diagnosis may be very difficult.

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Source
http://dx.doi.org/10.1016/j.ijscr.2021.105841DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047176PMC
March 2021

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