Situs inversus totalis with solid pseudopapillary pancreatic tumor: A case report and review of literature.

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Situs inversus totalis with solid pseudopapillary pancreatic tumor: A case report and review of literature.

Medicine (Baltimore). 2018 Mar;97(12):e0205

Authors: Xiang D, He J, Fan Z, Xiong F, Liu G, Chen S, Wen W, Li J, Ai J, Wan R, Wang G, Shi J

Abstract
RATIONALE: Situs inversus totalis (SIT) is a rare anatomical variation of the internal organs, and solid pseudopapillary tumor of the pancreas (SPTP) is a rare tissue type of pancreatic tumors, classified as benign or low-grade malignancy. However, to our knowledge, a patient with SIT and SPTP is extremely rare and has never been reported.
PATIENT CONCERNS: We retrospectively analyzed a case of SIT with SPTP in a 45-year-old woman. The main complaints were abdominal pain and sensation of heaviness for 2 weeks. There was tenderness and a mass that could be palpated in the right upper abdomen.
DIAGNOSES: Heart ultrasonography (USG), chest x-ray, computed tomography (CT), and contrast-enhanced computerized tomography (CECT) revealed a mirror-image dextrocardia and inversion of all abdominal viscera and a space-occupying lesion in the pancreas tail. Abdominal computed tomography angiography (CTA) showed no obvious abnormality of artery. The diagnosis of SPTP was finally made by postoperative pathological examination.
INTERVENTIONS: The patient underwent resection of the pancreatic body and tail and splenectomy via laparotomy to completely remove the tumor.
OUTCOMES: The patient was discharged with specific discomfort on postoperative day 7. At the 1.5-year follow-up, she recovered without issue.
LESSONS: Surgical resection remains the only effective treatment of SPTP. SIT with SPTP can be accurately diagnosed by heart USG, chest x-ray, CT, and CECT of the upper abdomen. Abdominal aorta CTA before surgery can decrease the injury risk of blood vessels.

PMID: 29561447 [PubMed - indexed for MEDLINE]

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