PMC6000649_01
a and b: US show an irregular and inhomogeneously hypoechoic mass with some calcifications inside.
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PMC6000649_01_gr1.jpg
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Furthermore, the exam showed, in perisplenic a voluminous mass of 7.7 x 6.6 cm, heterogeneously hypoechoic with microcalcifications and irregular contours (Fig. 1a and b) Computerized tomography showed massive solid neoformation, next to splenic hilum, which incorporated the pancreatic tail and the splenic hilum, likely attributable swelling confluent lymph nodes. (Fig. 2a and b).
a and b: CT with contrast enhancement during portal phase show a voluminous mass next to splenic hilum with splenic vein infiltration.
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PMC6000649_01_gr2.jpg
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Furthermore, the exam showed, in perisplenic a voluminous mass of 7.7 x 6.6 cm, heterogeneously hypoechoic with microcalcifications and irregular contours (Fig. 1a and b) Computerized tomography showed massive solid neoformation, next to splenic hilum, which incorporated the pancreatic tail and the splenic hilum, likely attributable swelling confluent lymph nodes. (Fig. 2a and b).
T2 W TSE-BH sequence axial (a) and coronal (b) views show the inhomogenous neoformation, hyperintense in T2 W sequence with irregular internal septa and partially encapsulated.
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T2 W sequence (Fig. 3a and b), hypointense signal on T1W and progressive contrast enhancement (Fig. 4a and b), with some calcifications and colliquative areas. The tumor seemed poorly separable from medial profile of the spleen, the pancreatic tail, and from the splenic artery and vein and also compressed the ipsilateral kidney and adrenal gland.
T1 red; T2 blue; T3 green; T4 orange.
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An additional 5-mm trocars were used below xiphoid (T4) (Fig. 5).
(a-d): well-developed capsule circumscribes neoplasms from normal pancreas (a); very cellular neoplasm with monotunous lightly eosinofilic cells (b); cells with ovoid nuclei and little nucleoli and occasional hyaline globules (c); pseudopapillae and cholesterol clefts (d).
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Histophatological result was solid tumor pseudopapillary of pancreas with no pathological lymph nodes (Fig. 6).