Infant solid cystic tumor of the pancreas conducted spleen preserving distal pancreatectomy-report of a case

Abstract

A 13-year-old girl admitted for a left-upper abdominal mass was found in abdominal ultrasonography and computed tomography to have a heterogeneous mass on the tail of the pancreas, 80mm in diameter. Abdominal magnetic resonance imaging showed high intensity in T2 weighted imaging, and abdominal angiography showed a hypovascular tumor without invasion to the splenic artery. We found splenic vein obstruction and-collateral blood flow via the left gastroepiploic vein. Endoscopic retrograde cholangiography and pancreatography showed compression and flection of the main pancreatic duct of pancreatic body and tail without interruption. She was operated on to remove a solid cystic tumor of the pancreatic tail. The capsulated tumor showed no other organ invasion but the splenic artery and vein were adhered tightly due to inflammation, and collateral blood flow via the left gastroepiploic vein involved obstruction of the splenic vein. We conducted spleen-preserving distal pancreatectomy with splenic vein resection. The resected specimen was a 90 x 90 x 85mm tumor with a small lobular pattern and slit but without cystic area. The tumor was confirmed to be sold cystic tumor in microscopically and immunostaining. Such a case is rare and offers insights into diagnosis and surgical procedures because, despite being benign, the tumor obstructed the splenic vein and caused collateral blood flow formation.