Clinical investigation of expansive retroperitoneal lesion suggestive of Frantz’s tumor: case report and review of literature

Abstract

Introduction: Pancreatic neoplasms represents 2% of tumors diagnosed in Brazil and are responsible for 4% of deaths due to neoplasms. About 10 to 15% of cases are cystic pancreatic neoplasms. Objective: To present a case of expansive retroperitoneal lesion suggestive of Frantz’s Tumor which anatomopathology report showed Mucinous Cystadenocarcinoma. Case report: Female, 30 years old, complaining of representative weight loss and obstructive gastrointestinal symptoms manifested progressively within 6 months. There were no comorbidities. Laboratory tests showed nothing abnormal. The computed tomography showed a complex retroperitoneal cystic expansive lesion in mesogastrium and left hypochondrium, with intimal relationship with body/tail of pancreas. She was submitted to tumor resection and Distal Pancreatectomy. The patient had good postoperative evolution with improvement in gastrointestinal symptoms. Anatomopathological analysis evidenced histology compatible with pancreatic mucinous cystic neoplasm, with mild and moderate epithelial dysplasia and areas of mucinous cystadenocarcinoma, moderately differentiated, with high-grade pleomorphic components. Discussion: The most common subtype of cystic pancreatic neoplasms is the Mucinous Cystadenocarcinoma, which can either be malignant at the moment of diagnosis or benign, with the possibility of malignization. There are other types as Serous Cystadenoma, Mucinous Cystadenoma, Intraductal Papillary Mucinous Neoplasm and Frantz Tumor. This last type presents with slowly growing and unspecific clinical manifestations, being diagnosed frequently when it has bigger dimensions. Conclusion: It was a case of Invasive Mucinous Cystadenocarcinoma with atypical presentation, similar to Frantz tumor. The diagnosis was possible due to the anatomopathological study, that showed to be a fundamental instrument for the differential diagnosis.