Sir,

Solid-cystic pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm, accounting for about 0.17% and 2.7% of all nonendocrine tumors of the pancreas.[1] It is most commonly seen in young women.[1],[2]

Recently, SPN is getting more frequently diagnosed in the Indian subcontinent as there is better diagnostic preevaluation and increased awareness about this uncommon tumor.[3],[4] Although it is predominantly seen in females, occasionally it can be seen in males.[1],[3] Ultrasound-guided fine-needle aspiration (FNA) is useful in providing preoperative diagnosis.[1] Whenever possible, trucut biopsy of the lesion should be done which can provide a histopathological diagnosis. Histopathologically, the main differential diagnoses of SPN are well-differentiated neuroendocrine neoplasm and acinar cell carcinomas.[2],[3] A panel of immunohistochemical markers along with clinical, imageological, and morphological findings may help in arriving at a conclusive diagnosis. The typical paranuclear positivity of CD99 aids in the diagnosis of SPN.[3],[5]

Although SPN is usually benign, malignant SPNs are known and metastasis also is described.[2] Complete surgical resection is associated with long-term survival even in the presence of metastasis, thereby making preoperative diagnosis important.[2]

To conclude, although SPN of the pancreas is a rare neoplasm, awareness and clinical suspicion about this uncommon are required to consider this tumor especially in young females. Ultrasound-guided FNA and/or trucut biopsy can help in arriving at preoperative diagnosis. Most of the SPNs are benign, and complete surgical resection remains the treatment of choice.

Acknowldgement

The authors wish to thank Prof. V. Suresh for his invaluable help.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.