Case report of peritoneal carcinomatosis in the clinical course of pancreatic solid pseudopapillary neoplasm (Frantz's tumor) in a patient with a history of blunt abdominal trauma

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Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Autores
DAMOUS, Sergio Henrique Bastos
YAMAZUMI, Marcia Harumi
CAVASSIN, Guilherme Pasquini
Citação
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, v.108, article ID 108472, 5p, 2023
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Resumo
Introduction: Pancreatic solid pseudopapillary neoplasm (SPN), or Frantz's tumor, is a rare tumor with low malignant potential and a high cure rate when treated by complete surgical resection. There have been few reports of metastatic disease as a result of blunt abdominal trauma. Presentation of case: A 13-year-old female patient was a victim of blunt abdominal trauma in 2019. A computed tomography (CT) scan showed a voluminous hemoperitoneum associated with a tumor in the pancreatic tail whose characteristics suggested a pseudopapillary tumor. The patient remained hemodynamically stable and nonoperative treatment was chosen. Two months later, a CT scan showed resolution of the hemoperitoneum and delimitation of the neoplasm in the tail of the pancreas. Elective body and tail pancreatectomy with laparoscopic splenectomy was performed. The patient remained asymptomatic for 15 months until she developed abdominal pain and constipation. A CT scan suggested peritoneal carcinomatosis, which was confirmed by biopsy of the lesions. Clinical discussion: A pancreatic SPN, in the context of an abdominal injury, can undergo metastatic progression despite surgical resection with curative intent and adherence to the precepts of minimally invasive oncological surgery. It is important to plan for the long-term follow-up of patients, as well as to understand the risk factors for recurrence. Conclusion: Although pancreatic SPN has a good prognosis, rupture of its capsule due to external trauma, as reported in the present case, may be a mechanism for peritoneal dissemination of the tumor with a consequent reduction in the length of disease-free survival.
Palavras-chave
Solid pseudopapillary neoplasm, Pancreatic tumors, Abdominal trauma, Blunt abdominal trauma
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