competitive inhibitor of KIT and platelet derived growth factor
receptor á (PDGFR á)and the results have been encouraging in
patients having unresectable or metastatic GISTs.8
KAMAL NAIN RATTAN1
VIVEK SINGH MALIK2
Correspondence: Dr. Pradeep Kajal,
Department of Pediatric Surgery1 and Anatomy2
PGIMS Rohtak, Haryana and Department of Anatomy
MAMC, Agroha, Haryana, India-124001
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BJ, et al. Diagnosis of gastrointestinal stromal tumors: A
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paradise for acronyms (STUMP, GIST, GANT, and now
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many emerging roles of the interstitial cell of Cajal in the
pathogenesis of gastrointestinal diseases? Adv Anat Pathol.
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Neuroectodermal differentiation of the gastrointestinal tumors in
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5. Rubin BP, Singer S, Tsao C, Duensing A, Lux ML, Ruiz R, et al.
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6. Berman J, O’Leary TJ. Gastrointestinal stromal tumor work-
shop. Hum Pathol. 2001;32:578–82.
7. Li P, Wei J, West AB, Perle M, Greco MA, Yang GC. Epithelioid
gastrointestinal stromal tumor of the stomach with liver metastases
in a 12-year-old girl: aspiration cytology and molecular study.
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8. Demetri GD, von Mehren M, Blanke CD, Van den Abbeele
AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib
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cystic and solid tumor of the
Most pancreatic tumors are malignant and have a bad
prognosis. However, papillary cystic and solid tumour of the
pancreas (PCSTP) is an unusual low-grade malignancy that
and the prognosis is excellent. It mostly affects young females
with a mean age of 25 years.2 It has also been referred to as a
solid-cystic epithelial tumour, solid-pseudopapillary tumour or
papillary-cystic tumour.3 It makes up 0.2–2.7% of all pancreatic
cancers.4 Since the original description by Frantz in 1959, the
incidence of PCSTP has been increasing,5 although it may be
that it is increasingly being diagnosed. Very few cases of PCSTP
have been reported from India.
1 Surgical resection is generally curative
A 29-year-old female presented with chronic epigastric and left
hypochondriac discomfort since 1 year. It was associated with
postprandial fullness and occasional vomiting. On examination
she was overweight and there was epigastric tenderness, vague
mass was palpable in the left hypochondrium which moved
with respiration. All haematological and biochemical parameters
were within normal limits. Abdominal ultrasonography
demonstrated partially cystic mass of 18 x 12 cm in distal
pancreas with a possibility of a neoplasm. Contrast enhanced
computed tomography (CT) scan confirmed 18 cm mass in the
tail of pancreas without any metastases.
The patient underwent staging laparoscopy which showed
large mass arising from the tail of the pancreas without any
metastases. An en-block spleen preserving distal
pancreatectomy, including the pancreatic mass, was performed
(Figure 1). The patient made an uneventful recovery.
On gross examination the pancreatic tumour was oval, 18
cm in diameter, and was surrounded by a fibrous
pseudocapsule. Its cut surface showed solid and cystic spaces.
On microscopy, the solid portion of the tumour revealed sheets
of uniform polygonal cells as well as non-cohesive papillae
arranged around fine fibrovascular cores. The cyst wall was
composed of dense acellular fibrous tissue within which the
tumour cells were arranged as cords and trabeculae set within
a mucinous background. No invasion of the tumour into
pancreatectomy for a large papillary
Tropical Gastroenterology 2012;33(4):287–289