Emergency multivisceral resection for spontaneous haemorrhage rupture of huge solid pseudopapillary neoplasm of the pancreas during pregnancy

Raheel Ahmad, Marco Baia, David N Naumann, Fahad Mahmood, Fabio Tirotta, Samuel Ford, Anant Desai, Max Almond

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Abstract

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare malignancy with a low malignant potential and strong female preponderance. Diagnosis during pregnancy is extraordinary, and management must consider the risks to the mother and foetus of tumour growth and rupture. A large 35-cm SPN was identified on magnetic resonance imaging (MRI) in a 24-year-old woman at 6 weeks of gestation following presentation with an abdominal mass. Surgery was delayed to allow the foetus to reach as close to term as possible because surveillance MRIs showed incremental mass growth. Emergency c-section was undertaken at 35 weeks of gestation due to persistent tachycardia and suspected haemorrhage into the tumour. A Hb of 70 g/l post-delivery despite four units of RBCs and an albumin of 11 g/l necessitated urgent multivisceral surgery. Surgical resection is the mainstay of treatment for SPN. However, the strategy of choice during pregnancy remains undetermined, with more recent reports delaying surgery until post-partum.
Original languageEnglish
Article numberrjac331
Pages (from-to)1-3
Number of pages3
JournalJournal of Surgical Case Reports
Volume2022
Issue number7
Early online date25 Jul 2022
DOIs
Publication statusE-pub ahead of print - 25 Jul 2022

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