A SOLID CYSTIC TUMOR OF THE PANCREAS IN A 12-YEAR-OLD MALE-MORE THAN TEN YEARS OF RECURRENCE-FREE FOLLOW-UP-

Solid cystic tumor of the pancreas is rarely seen in young males. We report here a solid cystic tumor of the pancreas in a boy who has had no recurrence for more than ten years. A 12-year-old Japanese male was admitted to our hospital in September 1987 complaining of dull upper abdominal pain. On admission, a 6cm tender, elastic hard mass was palpable in the upper abdomen. Routine blood studies yielded values within the normal range, except for moderate elevation of T-bil, GOT, GPT, and ALP. Serum neuron-specific enolase (NSE) was slightly elevated. Ultrasonography and a computed tomography scan revealed an encapsulated, cystic mass with a solid component, 6cm in diameter, located in the head of the pancreas, and a dilated gallbladder and intrahepatic bile duct. Percutaneous transhepatic gallbladder biliary drainage (PTGBD) was performed and cholangiography demonstrated narrowing of the distal common bile duct. Celia angiography revealed a hypovascular mass. Subsequently, pylorus-preserving pancreatico-duodenectomy was performed. The resected tumor measured 7.0×6.5×6.0cm, and was covered with a firm, fibrous capsule. Histological examination revealed that the cyst was lined by pseudopapillary epithelial cells, and that mitoses were rare. Immunohistochemical studies showed immunoreactivity for a α 1-antitrypsin (AAT) and NSE. We determined the tumor to be a solid cystic tumor of the pancreas. The patient has been well for ten years and eight months since surgery, with no signs of recurrence.