TITLE

Pancreatic Solid Pseudopapillary Neoplasm (PSPN): a retrospective review at our institution.

BACKGROUND & OBJECTIVES (*/40)

Initially considered a benign entity, PSPN was later reclassi ed as “Low grade malignant” (IVB
category —“Neoplasm-Other”—, Papanicolau Classi cation 2014), and currently belongs to the
VII category —“Malignant”— of the WHO Classi cation, 2022. We studied retrospectively the
prevalence at our center.

METHODS (*/60)
A retrospective descriptive study of pancreatic cytology performed by endoscopic ultrasound (EUS)
was carried out from January 2021 to January 2024, reviewing the medical records of cases
diagnosed with PSPN. We also examined the main publications regarding PSPN of the last ve
years and utilised the Papanicolau (2014) and WHO (2022) classi cations.

RESULTS (*/110)
In three years, 325 endoscopic ultrasound–guided ne needle aspiration cytology (EUS-FNA) of
pancreas were performed, four (1.23%) of which were diagnosed with PSPN. Three (75%) patients
were women. The average age was 32 years (19 – 50 years). The lesions measured between 4.5 and
6 cm. Abdominal pain was the main symptom in three cases. All cases were limited to the pancreas,
three (75%) of them to the head. Two cases were encapsulated. One of the cases occurred in
combination with in ltrating adenocarcinoma. Three cases were cystic. Three cases showed
calci cations. All cases showed nuclear and cytoplasmic positivity for beta-catenin. Three cases were
cyclinD1 positive and two were synaptophysin positive.

CONCLUSSION (*/80)
All patients were diagnosed with EUS-FNA (three con rmed in the surgical specimen), whilst other
series average a 63% of EUS-FNA performance. 75% were located in the head, while in other series
it predominates in the tail (27%) over the head (25.4%). During follow-up, none of them presented
metastasis, whereas in other series it occurs in 7.1%. All patients still alive, while in other series
PSPN associates a mortality of 4.8%. Our data is limited since we only had 325 EUS-FNA.
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