Laparoscopic enucleation of Frantz's tumor of the pancreas: Case report and literature review

Abstract

Introduction Frantz's tumor of the pancreas is a rare phenomenon, and it accounts for 1–3% of all neoplasms of the pancreas. Its percentage is much higher in younger persons, especially in younger women, as compared to the rest of the population. Presentation of case The present study describes a 32-year-old female patient in whom a preoperative imaging diagnosis confirmed a mass in the junction of the pancreas' body and tail. Based on the anamnesis, the preoperative diagnosis, and the patient's general status, the decision was made to performed laparoscopic enucleation of the pancreatic tumor. The operation and postoperative recovery passed without complications. Definitive histopathological and immunohistochemical findings confirmed a solid pseudopapillary neoplasm of the pancreas. Discussion Depending on the localization and the size of the tumor, surgical options range from typical and atypical resections of the pancreas to minimally invasive surgical procedures, such as local excision and enucleation. Laparoscopic procedures have a comparative advantage in cases of enucleation and resection of the pancreas. The low frequency of recidivation and a favorable prognosis, even after repeated surgery, are additional reasons for favoring the laparoscopic approach over the classical surgical approach. Conclusion A minimally invasive surgical approach should be applied whenever the dimensions and the localization of the tumor permit it, bearing in mind all the benefits and advantages that this surgical technique offers.

Frantz tumor in a 58 year old woman; case report and literature review

“…According to the literature, the most common presentation is abdominal discomfort (36.8 %), followed by abdominal pain, emesis and jaundice, in 12.3 % of patients the tumor can be palpated. There are no specific tumor markers; in the case of the patient, there was no elevation of Ca 19–9 or carcinoembryonic antigen [ 1 , 8 ].…”

“…The differential diagnosis after 40 years is with cystadenomas, cystadenocarcinomas, intraductal papillary mucinous neoplasms, teratomas and neuroendocrine tumors [ 2 , 8 ]. Depending on the location, a pancreaticoduodenectomy, a left pancreatectomy, or a central pancreatectomy may be chosen [ 9 ].…”

“…Global 5-year survival is 95–97 % as long as metastatic disease is not present. 10–15 % present with metastatic disease, the liver being the most frequently associated [ 1 , 8 , 11 ]. Associated poor prognostic factors are a tumor larger than 8 cm, cellular atypia, invasion of the capsule, lymphovascular invasion, and perineural invasion [ 10 , 14 ].…”

“…Most of the occasions they are detected incidentally, when there are symptoms these are usually nonspecific, such as abdominal pain or abdominal distention [ 7 ]. The diagnosis is established mainly with abdominal tomography or magnetic resonance imaging [ 8 ].…”

Prospects and applications of enucleation in solid pseudopapillary neoplasms of the pancreas

“…Solid pseudopapillary neoplasms (SPNs) of the pancreas account for approximately 1%-3% of all pancreatic neoplasms[ 1 , 2 ]. To date, surgery remains the only curative treatment for SPN patients[ 3 - 5 ].…”