Pancreatoblastoma : A case report

Abstract

A 2.5 year old female child was admitted to Dr. Sardjito Hospital with complaint of enlarging abdomen since 6 months. She was apparently well until 3 months prior to admission when she had anorexia and weight lost. Physical examination revealed a solid intrabdominal mass (15x13 cm) with smooth surface and no tenderness. USG of the abdomen showed a large mass in paraaortal region and
pushed the aorta. Operation was done and during exploration the mass was located as high as the stomach
level and extended into the pancreas. Gross examination showed the tumor was 11x11x8 cm, encapsulated,
nodular, white cut surface, some parts were brown and most of them were fragile. The diagnosis of
pancreoblastoma was established by immunohistochemical examination. The presenting features of pancreoblastoma are generally nonspecific and clinically difficult to distinguish
from other intraabdominal tumors such as neuroblastoma, non-Hodgkin lymphoma, Wilms tumor, hepatoblastoma and desmoblastoma. Some clinical tests might suggest these tumors, i.e. multiorgan involvement for non-Hodgkin lymphoma; renal origin, the propensity for venous invasion and for the
pulmonary metastasis for Wilms tumor. afeto protein that is positive in either hepatoblastoma or pancreoblastoma cannot differ both tumors. Another intrabdominal tumor that should be considered is desmoblastoma that positive vimentin stain. The positive CAM5.2. as well as cytokeratin and the negative vimentin in immunohistochemical examination confirmed the diagnosis of pancreoblastoma.
Keywords : pancreoblastoma child intraabdominal tumors immunohistochemical examination