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Li X, Ren J, Ke J, Jiang P, Guo L, Zhang L, Han W, Liu Y, Ji B. Solid pseudopapillary neoplasm of the pancreas with hepatic metastases: problems and strategies. Front Oncol 2024; 14:1410888. [PMID: 39099687 PMCID: PMC11294175 DOI: 10.3389/fonc.2024.1410888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
Background Solid pseudopapillary neoplasms of the pancreas with hepatic metastases are infrequent and difficult to diagnose, and treatment is uncertain. Methods A retrospective analysis of clinical data from patients with pancreatic solid pseudopapillary neoplasm (SPN) hepatic metastases who underwent surgery at the First Hospital of Jilin University from January 2005 to December 2021 was conducted. A total of 287 patients with SPN were included in the study, of which 8 (3%) developed liver metastases, all of whom were treated surgically and recovered well after surgery. The clinical presentation, imaging features, surgical treatment, histopathological examination, and postoperative follow-up data (mean 70 months; range 28-138 months) of the patients were recorded and analyzed. Clinical response strategies can be derived by reviewing previous studies on hepatic metastases of SPNs. Results For resectable hepatic metastases from pancreatic solid pseudopapillary neoplasms, early surgery with total resection of the primary tumor and metastasis has shown great efficiency and is associated with patient good prognosis. In patients presenting unresectable hepatic metastases, aggressive tumor reduction surgery resulted in the alleviation of clinical symptoms and reduction of tumor burden while potentially achieving long-term survival. Conclusion For hepatic metastases of SPNs, a preoperative liver tissue biopsy is beneficial for a definitive diagnosis. Surgery demonstrates excellent therapeutic efficacy and is considered the preferred curative treatment approach. This paper presents clinical experiences with SPN-related hepatic metastases at the Affiliated Hospital of Jilin University, which can be used to guide patient counseling in clinical practice.
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Affiliation(s)
- Xiaocheng Li
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, China
| | - Jiaxin Ren
- Department of Neurology, the First Hospital of Jilin University, Changchun, China
| | - Jianji Ke
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, China
| | - Peng Jiang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, China
| | - Liang Guo
- Department of Pathology, the First Hospital of Jilin University, Changchun, China
| | - Li Zhang
- Department of Radiology, the First Hospital of Jilin University, Changchun, China
| | - Wei Han
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, China
| | - Yahui Liu
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, China
| | - Bai Ji
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun, China
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Spontaneous regression in solid pseudopapillary neoplasm of pancreas. Clin J Gastroenterol 2023; 16:105-109. [PMID: 36214971 DOI: 10.1007/s12328-022-01715-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022]
Abstract
A solid pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm that mainly occurs in young women. We herein report the case of spontaneous regression in SPN of the pancreas. A 48-years-old female was found to have a mass in the head of the pancreas on examination for her back pain and referred to our hospital in 20XX. Laboratory data showed no abnormalities in serum levels of pancreatic enzymes and tumor markers. A contrast CT scan of upper abdomen showed a slightly enhanced lesion (23 × 19 mm in diameter) without cystic component or fibrous capsule in the head of the pancreas. An MRI scan showed the mass as low-intensity in T1-WI and high-intensity in T2-WI. She admitted to our hospital for further examination of a pancreatic mass by EUS-FNA in 20XX + 4. EUS showed a slightly hypoechoic mass (30 × 19 mm in diameter) compared with the neighboring normal pancreas. Tumor margin was relatively clear and the internal echo image was homogenous. Histological findings revealed a solid and pseudopapillary proliferation of eosinophilic polygonal cells with oval nuclei. The tumor cells were positive for vimentin and CD10 in the cytoplasm and β-catenin in the nuclei, which led to the diagnosis of SPN. We recommended this patient to undergo surgical resection, however, the patient chose follow-up examinations. Follow-up study after 1 year using MRI scan showed spontaneous regression, which was coincided with her menopause. These findings suggest that the natural regression of SPN may occur and female sex hormone changes may regulate the growth of SPN.
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Yalçın B, Yağcı‐Küpeli B, Ekinci S, Orhan D, Oğuz B, Varan A, Kutluk T, Akyüz C. Solid pseudopapillary neoplasm of the pancreas in children: Hacettepe experience. ANZ J Surg 2019; 89:E236-E240. [DOI: 10.1111/ans.15111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/15/2018] [Accepted: 01/25/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Bilgehan Yalçın
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Begül Yağcı‐Küpeli
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
- Department of Pediatric Hematology/OncologyAdana City Education and Research Hospital, Sağlık Bilimleri University Adana Turkey
| | - Saniye Ekinci
- Department of Pediatric SurgeryHacettepe University Faculty of Medicine Ankara Turkey
| | - Diclehan Orhan
- Department of PathologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Berna Oğuz
- Department of RadiologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Ali Varan
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Tezer Kutluk
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Canan Akyüz
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
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Erráez-Jaramillo PJ, Ortiz-Hidalgo C. [The histological and immunohistochemical diagnosis of solid pseudopapillary neoplasm of the pancreas and its differential diagnosis]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2019; 52:178-189. [PMID: 31213259 DOI: 10.1016/j.patol.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 02/23/2019] [Accepted: 03/03/2019] [Indexed: 01/12/2023]
Abstract
Solid pseudopapillary neoplasm of the pancreas is a rare tumor of uncertain histogenesis, described separately by Gruber and Frantz, that accounts for between approximately 1% and 3% of pancreatic neoplasms. It is characterized by a cystic and solid pattern of growth patterns with formation of pseudopapillae. It occurs primarily in young women, although cases in children and older patients and men have been reported. The tumor is of low-grade malignant potential, as the majority of the cases are cured by simple but complete surgical resection. Knowledge of the unique morphologic characteristics of this neoplasm is essential for the correct diagnosis. We review herein the pathologic and immunohistochemical features of this neoplasm and its differential diagnosis with other pancreatic tumors.
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Affiliation(s)
| | - Carlos Ortiz-Hidalgo
- Departamento de Anatomía Patológica, Hospital y Fundación Médica Sur, Ciudad de México, México; Departamento de Biología Celular y Tisular, Escuela de Medicina, Universidad Panamericana, Ciudad de México, México.
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Zhang JB, Shang D, Yeo TP, Cannaday S, Maley WR, Yeo CJ. A Persistent Solid Pseudopapillary Tumor of the Pancreas: Case Report and Brief Literature Review. Case Rep Pancreat Cancer 2015; 1:11-15. [PMID: 30631803 PMCID: PMC6319675 DOI: 10.1089/crpc.2015.29006.jbz] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Solid pseudopapillary tumors (SPTs) of the pancreas are uncommon neoplasms, first reported in 1934, well described by Frantz in 1959, and later further characterized by Hamoudi in 1970. Ninety percent of these tumors occur in young females in their second to third decade of life. An interesting case of a persistent solid pseudopapillary neoplasm is described in this report. Case presentation: A 24-year-old woman from a Middle Eastern country presented with an 8.2 × 7.6 cm heterogeneous-enhancing lesion growing within the uncinate process of the pancreas. She had first experienced symptoms at the age of 12 years. Imaging studies showed that the mass closely abutted the superior mesenteric vein as well as the superior mesenteric artery (SMA). The patient underwent an open cholecystectomy and a classic pancreaticoduodenectomy. During the resection, the SMA was transected due to tumor adherence. The vessel was subsequently reapproximated in an end-to-end manner. On the first postoperative day, thrombosis of the SMA occurred and a bile leak developed. The patient returned to the operating room for SMA embolectomy and for repair of a hepaticojejunostomy leak, with redo of the biliary-enteric anastomosis. Histopathological examination showed solid pseudopapillary-arranged cells and cystic areas, showing strong cellular immunoreactivity for CD56, CD10, vimentin, and β-catenin, and weak diffuse staining for synaptophysin. The tumor stained negative for chromogranin A, trypsin, AE1/AE3, and E-cadherin. Molecular genetic analysis was negative for the MYB gene deletion. At nearly 1 year of follow-up, the patient is well with no evidence of tumor recurrence. Conclusion: SPTs of the pancreas should be included in the differential diagnosis of pancreatic tumors, especially in young women.
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Affiliation(s)
- Jin Bao Zhang
- Department of Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dong Shang
- Department of Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Theresa P Yeo
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Shawnna Cannaday
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Warren R Maley
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Charles J Yeo
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Kang CM, Cho A, Kim H, Chung YE, Hwang HK, Choi SH, Lee WJ. Clinical correlations with (18)FDG PET scan patterns in solid pseudopapillary tumors of the pancreas: still a surgical enigma? Pancreatology 2014; 14:515-23. [PMID: 25256437 DOI: 10.1016/j.pan.2014.08.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 06/07/2014] [Accepted: 08/12/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are limited numbers of PET studies of solid pseudopapillary tumors (SPT) of the pancreas. MATERIALS AND METHODS We reviewed the medical records of 37 patients who underwent resection of pancreatic SPT and had been preoperatively evaluated by (18)F-FDG PET or PET/CT scan. Immunohistochemical analysis of glucose transporter-1 (GLUT-1) and hexokinase II (HK-II) was performed. RESULTS SPT could be categorized into five types according to the morphologic characteristics observed in PET images. Type I (hot FDG uptake in the entire tumor portion) was the most frequent (13, 34.2%), followed by type IV (focal uptake, 12, 31.6%), II (focal defect, 8, 21.1%), III (multiple and geographic uptake, 3, 7.9%), and V (total defective type, 1, 2.6%). The SUVmax in the solid portion of the SPT was 5.3 ± 4.1. The clinical pattern of FDG uptake in SPT was not associated with histopathologic features suggesting malignant potential. The SUVmax of SPT followed a pattern according to pattern of FDG uptake (R(2) = 0.203, p = 0.055), and was significantly associated with adjusted tumor volume (p = 0.001). GLUT-1 was not expressed in SPT, and only eight patients (12.3%) showed mild to moderate expression of HK-II, which was associated with the clinical pattern of SPT in PET images (p < 0.05). CONCLUSION SPT of the pancreas could be categorized according to the morphologic patterns observed in PET images. The clinical significance of FDG uptake, glucose metabolism, and clinical usefulness of PET scan in SPT need to be further investigated, and thus this tumor remains a surgical enigma.
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Affiliation(s)
- Chang Moo Kang
- Department of Surgery, Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic, Institute of Gastroenterology, Severance Hospital, Seoul, Republic of Korea.
| | - Arthur Cho
- Department of Radiology, Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic, Institute of Gastroenterology, Severance Hospital, Seoul, Republic of Korea
| | - Hyunki Kim
- Department of Pathology, Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic, Institute of Gastroenterology, Severance Hospital, Seoul, Republic of Korea
| | - Young Eun Chung
- Department of Radiology, Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic, Institute of Gastroenterology, Severance Hospital, Seoul, Republic of Korea
| | - Ho Kyoung Hwang
- Department of Surgery, Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic, Institute of Gastroenterology, Severance Hospital, Seoul, Republic of Korea
| | - Sung Hoon Choi
- Department of Surgery, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Republic of Korea
| | - Woo Jung Lee
- Department of Surgery, Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic, Institute of Gastroenterology, Severance Hospital, Seoul, Republic of Korea.
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Yoon HJ, Lim JH. Solid pseudopapillary tumor of the pancreas with hepatic metastasis: spontaneous regression over 10-year follow-up period. Korean J Radiol 2012; 13:648-51. [PMID: 22977335 PMCID: PMC3435865 DOI: 10.3348/kjr.2012.13.5.648] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 11/24/2011] [Indexed: 11/15/2022] Open
Abstract
A solid-pseudopapillary tumor (SPT) of the pancreas is known as a low grade malignant tumor with a good prognosis; therefore, surgical intervention is necessary. A 14-year-old boy presented with a large pancreatic SPT and three hepatic metastases. The patient and his family refused surgery. Two serial follow-up CT scans over a period of 13 years demonstrated almost complete disappearance of the pancreatic tumor and three hepatic metastases without relevant treatment. Although there have been a few reports of spontaneous healing of SPT, there has been no report regarding spontaneous disappearance of SPT and distant metastasis. Herein, we report on the spontaneous regression of a large SPT and the disappearance of three hepatic metastases.
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Affiliation(s)
- Hyun Jung Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
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9
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Herreros-Villanueva M, Hijona E, Cosme A, Bujanda L. Spontaneous regression of pancreatic cancer: Real or a misdiagnosis? World J Gastroenterol 2012; 18:2902-8. [PMID: 22736913 PMCID: PMC3380317 DOI: 10.3748/wjg.v18.i23.2902] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 03/04/2012] [Accepted: 03/20/2012] [Indexed: 02/06/2023] Open
Abstract
Spontaneous tumor regression has been subject of numerous studies and speculations for many years. This phenomenon is exceptional, but well reported, in some types of tumors, but not in pancreatic cancer. Pancreatic cancer has the worst five-year survival rate of any cancer. Despite numerous molecular studies and clinical approaches, using several mouse models, this cancer responds poorly to the existing chemotherapeutic agents and progress on treatment remains elusive. Although pancreatic cancer tumors seldom undergo spontaneous regression, and some authors take that with skepticism, there are some cases reported in the literature. However, the variability in the description of the reports and technical details could make this process susceptible to misdiagnosis. Distinguishing between different types of pancreatic carcinoma should be taken with caution as they have wide differences in malignant potential. Diseases such as pancreatic benign tumors, insulinomas, or autoimmune pancreatitis could be responsible for this misdiagnosis as a pancreatic cancer. Here we review different cases reported, their clinical characteristics, and possible mechanisms leading to spontaneous regression of pancreatic cancer. We also discuss the possibilities of misdiagnosis.
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Crucitti A, Grossi U, Giustacchini P, Tomaiuolo PMC, Bellantone R. Solid pseudopapillary tumor of the pancreas in children: report of a case and review of the literature. Updates Surg 2011; 62:69-72. [PMID: 20845104 DOI: 10.1007/s13304-010-0006-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Solid pseudopapillary tumor (SPT) of the pancreas is an infrequent neoplasm of low malignant potential, first described by Frantz in 1933 and representing less than 3% of all exocrine tumors. SPT is rare in children, accounting for 6% of all cases and shows different clinical features compared with adults. Here, a pediatric case is reported and a review of the Literature is provided. A 15-year-old girl with a 12 × 14 × 10 cm solid mass growing from the tail and the body of the pancreas, involving spleen, left adrenal gland and kidney, stomach and some bowel loops, was referred for surgical treatment. A distal pancreasectomy with splenectomy was performed. Histopathological examination revealed that the tumor was a 14-cm well-circumscribed solid mass, with pseudopapillary cell architecture, showing strong cellular immunoreactivity for alpha-1 antitrypsin, vimentin, neurone-specific enolase, progesterone receptors and in part to CD10 and CAM 5.2, but not to sinaptofisin and chromogranin. A 24-month post-surgical follow-up after successful surgical resection showed no evidence of recurrent disease. SPT shows different clinical features in childhood. High survival rates can be achieved in most cases, warranting aggressive treatments even in metastatic disease.
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Affiliation(s)
- Antonio Crucitti
- Dipartimento di Scienze Chirurgiche, Policlinico "A. Gemelli", Catholic University of the Sacred Heart, Largo A. Gemelli, 8, 00168 Rome, Italy.
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Zuriarrain A, Nir I, Bocklage T, Rajput A. Pseudopapillary tumor of the pancreas in a 17-year-old girl. J Clin Oncol 2011; 29:e395-6. [PMID: 21343547 DOI: 10.1200/jco.2010.33.5364] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Schlitter AM, Esposito I, Klöppel G. Klassifikation und Diagnose zystischer Pankreastumoren. VISZERALMEDIZIN 2011. [DOI: 10.1159/000329194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Soloni P, Cecchetto G, Dall'igna P, Carli M, Toffolutti T, Bisogno G. Management of unresectable solid papillary cystic tumor of the pancreas. A case report and literature review. J Pediatr Surg 2010; 45:e1-6. [PMID: 20438906 DOI: 10.1016/j.jpedsurg.2010.02.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 02/09/2010] [Accepted: 02/11/2010] [Indexed: 01/15/2023]
Abstract
Pancreatic solid papillary cystic tumor is a rare neoplasm with an excellent prognosis if surgical excision is complete. We report on a case and review 47 more cases extracted from the published literature to assess the treatment options when solid papillary cystic tumor is considered unresectable. Chemotherapy and radiotherapy were beneficial in a limited number of patients, but therapeutic decisions must be made bearing in mind that patients may be long-term survivors without any treatment because of the tumor's slow growth.
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Affiliation(s)
- Pietro Soloni
- Division of Hematology/Oncology, Department of Pediatrics, University Hospital of Padova, 35128 Padova, Italy
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Solid-pseudopapillary tumor of the pancreas in a 12-year-old girl – 7 years follow-up and histopathological reevaluation: Case report and subject review. Eur Surg 2010. [DOI: 10.1007/s10353-010-0525-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Suzuki M, Shimizu T, Minowa K, Ikuse T, Baba Y, Ohtsuka Y. Spontaneous shrinkage of a solid pseudopapillary tumor of the pancreas: CT findings. Pediatr Int 2010; 52:335-6. [PMID: 20500490 DOI: 10.1111/j.1442-200x.2010.03039.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Chakhachiro ZI, Zaatari G. Solid-pseudopapillary neoplasm: a pancreatic enigma. Arch Pathol Lab Med 2010; 133:1989-93. [PMID: 19961258 DOI: 10.5858/133.12.1989] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2009] [Indexed: 11/06/2022]
Abstract
Solid-pseudopapillary neoplasm of the pancreas is a relatively uncommon tumor. It typically affects young women, has nonspecific clinical and radiologic manifestations, and can be readily diagnosed by ultrasound-guided fine-needle aspiration and histopathologic evaluation. Histologic features characteristically show loosely cohesive, relatively uniform polygonal cells surrounding delicate capillary-sized blood vessels. Other features include cytoplasmic vacuolization, finely stippled chromatin, nuclear grooving, eosinophilic hyaline globules, and degenerative changes. Almost all solid-pseudopapillary neoplasms harbor mutations in the beta-catenin gene. They stain with beta-catenin, CD10, and focally with neuroendocrine markers. Although previously considered benign, this tumor is currently considered a low-grade malignant epithelial neoplasm with low metastatic rate and high overall survival. Most patients are cured by complete surgical excision. Despite the characterization of the morphologic and molecular features of this enigmatic neoplasm, more work is needed to uncover its cell of origin and true histogenesis.
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Affiliation(s)
- Zaher I Chakhachiro
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Liu GJ, Li XH, Wang L, Li HG, Liu ZH. Clinical features and surgical treatment for solid pseudo-papillary tumor of the pancreas. Shijie Huaren Xiaohua Zazhi 2008; 16:3457-3459. [DOI: 10.11569/wcjd.v16.i30.3457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To summarize the clinical features of and surgical treatment for solid pseudo-papillary tumor of the pancreas (SPTP).
METHODS: Eleven cases of SPTP diagnosed between January 2001 and April 2008 in our hospital were retrospectively analyzed. The main indicators included clinical features, B ultrasound and CT scan characteristics, pathological results and follow-up, etc.
RESULTS: Two cases of tumors were located in the pancreatic head, one tumor was in the neck of pancreas and 8 tumors were in the body and tail of pancreas. There were no specific clinical manifestations except 2 cases with acute abdominal pain. Solid and solid-cystic masses of low echo were found in pancreas under ultrasonic examinations. CT scan showed masses of low density in pancreas, while irregular enhancement appeared in the circumference of all tumors in enhanced CT scan sequences. Tumor markers in patients' serum were all negative except one case. Pancreaticoduodenectomy was performed on 3 cases. Simple resection of tumor was performed on 3 cases. Five patients underwent distal pancreatectomy and spleen resection. Ten patients were followed up with the average time of 23.7 months. No evidence of relapses and metastasis in these cases was found.
CONCLUSION: Solid pseudo-papillary tumor of pancreas is one of rare pancreatic neoplasm with low malignant potential, affecting primarily young women. Patients with SPTP have a favorable outcome after surgical treatment.
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