Diagnosis of large, heterogenous lesions of the pancreas with solid and cystic components is often challenging. The spectrum of differential diagnoses is broad, and clinical as well as radiological findings may be similar.
Detailed analysis of a clinical case and review of literature
We present the case of a 28-year-old woman with a large, heterogenous tumour of the pancreatic head that was incidentally found in routine ultrasound during pregnancy. The presence of a solid pseudopapillary neoplasm (SPN) was suspected because of typical clinical and radiological characteristics. The patient underwent partial pancreatoduodenectomy and surprisingly, histological work-up confirmed a pancreatic extra-gastrointestinal stromal tumour (EGIST).
As clinical and radiological findings may be misleading in a large, heterogenous tumour of the pancreas, a biopsy with histological proof of diagnosis is recommended, especially in situations where a neoadjuvant treatment may be considered.