Pseudopapillary solid tumour of the pancreas in paediatric age: description of a case report and review of the literature

Brillantino, Carmela; Rossi, Eugenio; Pirisi, Pietro; Gaglione, Giovanni; Errico, Maria Elena; Minelli, Rocco; Menna, Biagio F; Zeccolini, Raffaele; Zeccolini, Massimo

doi:10.1007/s40477-021-00587-7

Cited by 11 publications

(4 citation statements)

References 26 publications

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“…Generally, a large cystic component, calcification, and fat tissue are features of the benign SCT, while the malignant SCT is predominantly solid with fairly frequent hemorrhage and necrosis. Our case, therefore, confirms that imaging cannot reliably predict the histopathologic diagnosis as the tumor contained numerous cysts with simple fluid content, was primarily external in location, and seemed benign; on the other hand, the destruction of the bones of the pelvis, invasion of surrounding organs or metastatic disease were not present [6] , [7] , [13] , [14] , [15] , 19] . Total excision of the mass including coccygectomy within the few days of life is the main treatment for malignant SCT.…”

Section: Discussionsupporting

confidence: 64%

“…As in our case, the MRI is primarily used for evaluation of intraspinal invasion and for excluding the meningocele and myelomeningocele which are birth defects, grouped together under the term spina bifida cystica, looking like a sac filled with fluid leading out from the newborn's spine. Moreover, MRI is the modality of choice for the detection of neoplastic recurrence during follow-up, as it does not expose children to ionizing radiation and provides superior soft-tissue characterization to CT, exploiting the properties of magnetic fields to obtain images with high contrast resolution, acquired directly in 3 dimensions [6] , [7] , [9] , [10] , [13] , [14] , [15] , [18] , [19] . SCTs appear as complex masses, containing variable amounts of solid heterogeneous and cystic areas with or without septations, and imaging findings alone cannot differentiate between benign and malignant lesions.…”

Section: Discussionmentioning

confidence: 99%

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Giant malignant sacrococcygeal germ cell tumor in a newborn: A rare case report

Brillantino

Errico

Minelli

et al. 2022

Radiology Case Reports

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Giant malignant sacrococcygeal germ cell tumor in a newborn: A rare case report

Brillantino

Errico

Minelli

et al. 2022

Radiology Case Reports

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“…Unlike cases of childhood malignancy or empyema, axial imaging by MRI or human tissue biopsy will almost never be available to validate lung ultrasound findings [ 27 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

Validating a bovine model for lung ultrasound of bronchiolitis

et al. 2022

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Purpose Bronchiolitis is a very common acute lung disease in infants caused commonly by respiratory syncytial virus (RSV). Point-of-care lung ultrasound is increasingly used in clinical care but proof that ultrasound reflects histological disease is lacking. Bovine calves are a good model for RSV bronchiolitis. We answered the following two questions: (1) does point-of-care lung ultrasound reflect lung pathology at the histological level in a bovine calf model of bronchiolitis? and (2) are point-of-care lung ultrasound images in human infants similar to those obtained in calves? Methods We experimentally infected 24 five to six-week-old bovine calves with RSV and compared six window lung ultrasound with lung histology10 days after inoculation. The calves were treated with antivirals and antipyretics leading to variable severity of illness. We used canonical discriminant analysis to determine if abnormal lung ultrasound findings reflected different histological findings. We compared the ultrasounds obtained from the calves with ultrasounds obtained from 10 human infants who were diagnosed clinically with bronchiolitis. Results Canonical discriminant analysis generally demonstrated good class separation based on the maximal severity of ultrasound finding in each acoustic window. Lung ultrasound performed poorly at detecting bronchopneumonia. Bovine ultrasounds looked similar to human infant lung ultrasounds. Conclusion Point-of-care lung ultrasound abnormalities reflect lung pathology at the histological level in a bovine calf model of bronchiolitis. Point-of-care lung ultrasound images in human infants are similar to those obtained in calves.

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“…Pediatric pancreatic tumors are extremely rare. However, pancreatic SPNs are the most common pancreatic tumors in children, with approximately 20% cases occurring in children [2]. Generally, PD is a surgical procedure that is rarely performed in children due to the rarity of diseases with lesions that might occur in their pancreatic heads.…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic fatty liver disease developed after pancreatoduodenectomy for solid pseudopapillary neoplasm in a 10-year-old girl: a case report

et al. 2022

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Background Solid pseudopapillary neoplasms of the pancreas are rare. Moreover, pancreatoduodenectomy (PD) and postoperative care are not common in pediatric surgery. Herein, we report a case of PD and nonalcoholic fatty liver disease (NAFLD) after PD and present a literature review. Case presentation A 10-year-old girl with a suspected liver tumor was referred to our hospital. Echography, enhanced computed tomography and magnetic resonance imaging showed that the tumor coexisted with the solid and cystic parts of the pancreatic head. Since the patient was a young woman and the imaging findings were consistent with that of pancreatic solid pseudopapillary neoplasms (SPNs), we diagnosed her with pancreatic SPN. Thereafter, PD was performed, and she was discharged 10 days after the operation. Although her postoperative course was mostly uneventful, she experienced few episodes of abdominal pain and diarrhea before hospital discharge. These symptoms subsequently became more frequent and severe. The patient was urgently readmitted to the hospital for watery steatorrhea and lower abdominal colic pain. Her serum aspartate aminotransferase and alanine aminotransferase levels were elevated, and a fatty liver was detected on echography. The patient was diagnosed with steatorrhea, peristaltic pain, and NAFLD after PD. Pancrelipase (containing pancreatic digestive enzymes), antidiarrheal agents, and probiotics were started. Dosage increase of these drugs reduced the defecation frequency and abdominal pain and switched diarrhea to loose stools. However, more lipids in meals or more meals caused diarrhea and abdominal pain. Therefore, the doses of these drugs were further increased, and another antidiarrheal agent, loperamide hydrochloride, was added. Exocrine pancreatic enzymes supplementation and careful follow-up should prevent NAFLD progression after PD. At present, the patient has occasional abdominal pain, but has tangible soft stools once or twice a day. Although echography still shows a mottled fatty liver, her hepatic enzymes are only mildly elevated. Conclusions Pediatric PD is rare, and residual pancreatic function is usually sufficient, unlike in adult cases. However, we experienced a case of NAFLD after PD for a pediatric pancreatic SPN, in which pancreatic enzyme supplementation effectively improved this condition. Further attention must be paid to worsening of NAFLD that can develop nonalcoholic steatohepatitis.

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Pseudopapillary solid tumour of the pancreas in paediatric age: description of a case report and review of the literature

Cited by 11 publications

References 26 publications

Giant malignant sacrococcygeal germ cell tumor in a newborn: A rare case report

Giant malignant sacrococcygeal germ cell tumor in a newborn: A rare case report

Validating a bovine model for lung ultrasound of bronchiolitis

Nonalcoholic fatty liver disease developed after pancreatoduodenectomy for solid pseudopapillary neoplasm in a 10-year-old girl: a case report

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