Spontaneous regression of solid-pseudopapillary neoplasms with hepatic metastases

A 42-year-old female patient was presented to our hospital due to abdominal distension for 3 weeks. MRI scan showed a huge mass (16 cm diameter) in the pancreatic tail and irregular low-density shadows (0.4–5.6 cm diameter) in the liver with left outer lobe atrophy (Panel A). These lesions have increased radioactive uptake in PET/CT (Panel B). The patient underwent distal pancreatectomy, splenectomy, left lateral hepatectomy and pathological examination confirmed the diagnosis of solid-pseudopapillary neoplasms (Panel C; staining method HE, magnification ×20).

The remaining liver metastases were not treated post-operation. At 20 months follow-up, enhanced CT of the abdomen showed shrinkage and disappearance of the liver metastases, with no further distant metastatic disease (Panel D). Spontaneous regression of the hepatic metastases may be attributed to primary tumor resection tipping the immune-mediated balance towards the host, enabling or stimulating the immune system to control residual disease. However, the pathophysiological basis of this phenomenon remains to be investigated.

Acknowledgments

Funding: This study was financially supported by the Specific Project for Medical and Health Talent of Jilin Province (Grant No. JLSCZD2019-021).

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