image:
Histopathological and immunohistochemical features of the solid pseudopapillary neoplasm. ( A ) Basophilic calcifications within hyalinized fibrous areas (arrows) (H&E, ×400). ( B ) Tumor with focal infiltration by foamy histiocytes (arrows) (H&E, ×400). ( C ) Cholesterol clefts accompanied by multinucleated giant cells (H&E, ×400). ( D ) Tumor cells showing positive nuclear immunostaining for β-catenin (immunohistochemistry, ×400).
Credit: Copyright: © 2026 Limaiem and Hajri. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
“This case underscores the diagnostic value of integrating imaging, histopathology, and immunohistochemistry.”
BUFFALO, NY — March 6, 2026 — A new case report was published in Volume 13 of Oncoscienceon February 7, 2026, titled “Massive calcified solid pseudopapillary neoplasm of the pancreatic head.”
Led by Faten Limaiem — who is also the corresponding author and affiliated with Hospital Mongi Slim La Marsa in La Marsa, Tunisia — and co-author Mohamed Hajri, the report describes a 31-year-old woman who presented with progressive right-upper abdominal pain and was found to have a very large (≈12.5 × 9 × 8 cm), lobulated pancreatic-head mass with solid, cystic, and unusually coarse calcified components. The patient underwent a cephalic pancreaticoduodenectomy (Whipple procedure), and histology plus immunohistochemistry (nuclear β-catenin, CD10 positivity) confirmed a diagnosis of solid pseudopapillary neoplasm (SPN).
“Complete surgical resection remains the definitive treatment and yields an excellent prognosis, even in large, calcified cases.”
Imaging (contrast CT and MRI) showed a well-encapsulated, heterogeneous mass abutting but not invading adjacent organs or major vessels; tumor markers (CEA, CA19-9) were within normal limits. Gross pathology demonstrated cystic degeneration, hemorrhage, and coarse calcifications; microscopy revealed classic solid and pseudopapillary architecture with low mitotic activity. The postoperative course was uneventful and the patient remained recurrence-free at five months of follow-up. These features — large size and heavy calcification yet indolent histology — illustrate how SPN can mimic other pancreatic neoplasms and why integrated radiologic and pathologic assessment is essential.
The authors place the case in context: SPN is rare (under ~3% of exocrine pancreatic tumors), predominantly affects young women, and generally carries an excellent prognosis after complete resection. They emphasize that extensive calcification is uncommon but should be recognized as part of the SPN spectrum rather than a decisive marker of aggressive behavior. The report reinforces surgical resection as the treatment of choice and recommends multidisciplinary evaluation and long-term follow-up (at least five years) to monitor for the rare cases that recur.
DOI: https://doi.org/10.18632/oncoscience.642
Correspondence to: Faten Limaiem – faten.limaiem@fmt.utm.tn
Abstract video: https://www.youtube.com/watch?v=6RsOBk7g2aM
Keywords: cancer, solid pseudopapillary neoplasm, pancreas, surgery, pathology, immunohistochemistry
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Journal
Oncoscience
Method of Research
Case study
Subject of Research
People
Article Title
Massive calcified solid pseudopapillary neoplasm of the pancreatic head
Article Publication Date
7-Feb-2026
COI Statement
Authors have no conflicts of interest to declare.