Solid and Papillary Neoplasm of the Pancreas Clinical Review and Immunohistochemical Staining of 16 Cases Dae Kyum Kim, Sang Ik Noh, Jin Seok Heo, Jae Hyung Noh,Tae Sung Sohn, Seong Ho Choi, Yong Il Kim,Young Lyun Oh* Department of Surgery and Diagnostic Pathology*, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea Fig. 5 Monomorphous tumor cells surround delicate fibrovascular stalks of stroma and tradeculae enclose groups of tumor cells (Left, H & E, X100). Progesterone receptor were positive in nuclei of tumor cells. (Right, Green colored arrow; Anti-progesterone receptor staining, X 200). Introduction Patients and Methods Results Conclusion Solid and papillary neoplasms (Solid-pseudopapillary tumors) of the pancreas are rare tumors but interesting because it have good prognosis with surgical resection. The histopathogenesis of these tumors is unclear and still under consideration. Although these tumors occur predominantly in young women, it is still controversial whether sex hormonal factor play a role in pathogenesis. Duration : From Oct to Dec in Samsung Medical Center Patients : 16 cases were diagnosed with SPN pathologically. They were Reviewed retrospectively. Review consisted of clinical findings including imaging, immunohistochemistry and clinical follow-up. Immunohistochemical Staining Anti-Neuron specific enolase (NSE)1:80 Anti-Chromogranin 1:300 Anti-Somatostatin1:30 Anti-  antitrypsin1:600 Anti-  antichymotrypsin1:1600 Anti-Estrogen receptor (ER)1:100 Anti-Progesterone receptor (PR)1:80 Solid and papillary neoplasm (Solid-Pseudopapillary tumor) of the pancreas may be completely curable with complete resection. Immunohistochemical staining suggests that the origin of the tumor is totipotential primordial cells. Sex hormone may take play a role in the pathogenesis. 1.Age and Sex Age (years) MaleFemaleTotal < ~ ~ ~ ~ > Total Mean age (years) Clinical Findings 2. Clinical Findings 3. Radiologic Findings (Fig.2) No, of patients (%) CT Findings (n*=16) Cystic mass 11 (68.8) Solid mass 5 (31.2) Calcification in mass 6 (37.5) Angiographic findings (n*=3) Hypervascular mass 1 (33.3) Hypovascular mass 1 (33.3) Non-specific finding 1 (33.3) *n; CT was performed in 16 cases and angiography in 3 cases. 5. Size of tumors 4. Location of tumors 6. Operation and Postoperative course No. of patients Operation Pancreaticoduodenectomy 3 Distal pancreatectomy13 Postoperative complication Yes* 1 No 0 Recurrence Yes 0 No**16 * A case of intraabdominal abscess, who was cured with percutaneous drainage procedure. ** In postoperative pathology, there was no case of malignancy. 6. Immunohistochemical Staining (Fig.5) Positive (%)Negative (%) Total NSE14 (100.0) 0 ( 0.0) 14 Chromogranin 3 ( 27.3) 11(72.7) 14 Somatostatin 4 ( 30.8) 9 (69.2) 13  Antitrypsin14 (100.0) 0 ( 0.0) 4  Antichymotrypsin 3 (100.0) 0 ( 0.0) 3 Estrogen receptor 2 ( 14.3) 12(85.7) 14 Progesterone receptor 6 ( 42.9) 8 (57.1) 14 Abdominal pain 8 No symptom & sign 6 Mass 3 DM 2 Fig.1 Clinical findings 5. Size of tumors 1 Fig.4 Size of tumors 2345 No. of patients >12.0 cm 9.1~12.0 cm 6.1~ 9.0 cm 3.1~ 6.0 cm <3.0 cm, Mean size= 6.5 cm Mass Calcification Fig.2 CT and Trans-sectional gross finding of the pancreas. A 51 year-old woman presented with abdominal pain. Pacreatic cystic mass with calcification was showed in CT (Left). The mass was composed of necrotic cystic portion and solid portion and there was calcification in the wall of cyst (Right). Fig. 3 Green rounds indicate tumors. The most common tumor location was tail of the pancreas.