Solid-pseudopapillary neoplasms of the pancreas: clinical and pathological features of 33 cases

Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University College of Medicine, No. 88 Jiefang Road, Zhejiang, People's Republic of China.
Surgery Today (Impact Factor: 1.21). 07/2012; 43(2). DOI: 10.1007/s00595-012-0260-3
Source: PubMed

ABSTRACT PURPOSE: Solid-pseudopapillary neoplasms (SPNs) are rare pancreatic tumors, with a low potential for malignancy. The clinical and pathological features of 33 SPNs were reviewed. METHODS: This study conducted a retrospective analysis of 33 patients who underwent surgery for a pathologically confirmed SPN from 2000 to 2011. RESULTS: Thirty of the 33 patients (91 %) were female, and the median age at diagnosis was 29.2 years (range 12-59). The most common symptom was abdominal discomfort with dull pain (58 %). Others included asymptomatic lesions that were only detected incidentally during imaging (21 %), a palpable abdominal mass (15 %) and indigestion (6 %). All 33 patients underwent surgery with a curative intent and 3 (9 %) underwent laparoscopic surgery. The mean diameter of the tumors was 4.9 cm (range 2-15 cm), and they occurred in the head (9, 27 %), neck (5, 15 %), body or tail (19, 58 %) of the pancreas. One patient had lymph node metastases, one patient had portal venous invasion and 8 patients had perineural invasion. The patient follow-up ranged from 4 to 118 months, and 32 patients were alive and well without recurrence. One patient relapsed 10 months after distal pancreatectomy with splenectomy and underwent a second surgery via laparotomy. Unfortunately, the patient died of multiple organ failure 12 days after the second surgery. CONCLUSION: SPNs are rare neoplasms with malignant potential but excellent prognosis. Adequate surgical resection, including laparoscopic surgery, may therefore be performed safely and is associated with a long-term survival, even in invasive cases.

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    ABSTRACT: Solid pseudopapillary tumour is a rare indolent neoplasm of the pancreas (< 2% of exocrine pancreatic tumours), which predominantly affects young women at reproductive age, without significant clinical symptoms. We report a case of a 20-year-old Caucasian female who presented with upper abdominal pain of one-year duration. Ultrasound scans of the abdomen demonstrated enlarged pancreatic head and body containing a poorly separated mass (52 × 41 × 36 mm) with a multi-cystic component 20-24 mm in diameter. Laboratory tests including, tumour markers levels, were normal. She underwent complete resection of the tumour using a Beger procedure. By immunohistochemistry, the case stained strongly for CD10 and CD56 and was negative for cytokeratin-7 (CK-7), synaptophysin and chromogranin A. The proliferation index (Ki-67) was < 1%. The patient is being followed-up and remains healthy. Solid pseudopapillary tumour is a tumour with low potential of malignancy and with generally favourable prognosis; surgical resection is usually curative.
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    ABSTRACT: Solid pseudo papillary tumor (SPT) or Frantz's tumor is a slow-growing low-grade malignant tumor, commonly seen in young patients with a female predominance, which is commonly located in the body and tail of the pancreas. We report a case of SPT arising from the body of the pancreas in a 12-year-old girl who presented with acute abdomen and was treated successfully by local excision of the tumor with preservation of head of pancreas and spleen.
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    ABSTRACT: Solid pseudopapillary neoplasms (SPNs) of the pancreas are very rare neoplasms. The present study is to summarize our experience of the diagnosis, surgical treatment and prognosis of SPNs. The clinical data of 19 cases that underwent surgery for pathologically confirmed SPNs, admitted in our hospital from Mar. 2007 to Mar. 2013, were analyzed retrospectively. The clinicopathologic feature, surgical treatment and prognosis were described in detail. The 19 patients were 17 females and 2 males, with a median age of 29 years. All patients had curative resections, including eight distal pancreatectomies with splenectomy, four spleen-preserving distal pancreatectomies, two pancreaticoduodenectomies, two pylorus-preserving pancreaticoduodenectomies, two duodenum-preserving pancreatic head resections and one central pancreatectomy. The tumors were 6.3 cm in diameter on average, and were mostly located in the body or tail of the pancreas (63.2%). Pathologically, the tumors contained a mixture of solid, cystic, and pseudopapillary patterns in various proportions. None of the patients had lymph nodes metastases and local invasion. All patients were alive and disease-free at a median follow-up of 38.4 months. SPNs are rare neoplasms, typically affecting young women without notable symptoms, with a low malignant potential but excellent prognosis. Radical surgical resection with clear margins is the treatment of choice.