A Case of Successful Resection for Peritoneal Recurrence of Solid-pseudopapillary Tumor of the Pancreas Occurred in 6.5 Years after Rupture of the Tumor

隆典, 京兼; 晋輔, 弥政; 直規, 澤崎; 由一郎, 東島; 秀成, 後藤; 眞佐男, 松田; 榮, 村上

doi:10.5833/jjgs.41.1815

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…Tumor rupture during pancreatic laparoscopic resection is a matter of great concern due to the possibility of neoplasia dissemination. 28–31 Although SPT recurrence was not observed in our patient with tumor rupture, its occurrence during laparoscopic pancreatectomy emphasizes that the surgeons should be very careful in performing this procedure in large tumors. SPTs are usually large.…”

Section: Discussionmentioning

confidence: 55%

Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Coelho

Costa

Ramos

et al. 2018

JSLS

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Background and Objectives:Although solid pseudopapillary tumor (SPT) of the pancreas is rare, its diagnosis has increased severalfold in the past decades. We present our experience in the management of SPT, including a patient who experienced tumor rupture during laparoscopy pancreatic resection.Methods:Data on all patients with SPT who were subjected to surgical treatment were retrospectively obtained.Results:Of 20 patients evaluated, 17 (85%) were females. The mean age was 31 years. Tumor size varied from 2.7 × 1.5 to 13.5 × 10.0 cm, with a mean of 6.4 × 7.6 cm. The most common location was the tail and/or body of the pancreas (14 patients [70%]). Pancreatic tumor resection was performed in 19 patients (50%). The type of resection depended on tumor location and size: distal pancreatectomy (n = 13), pancreatoduodenectomy (n = 5), and central pancreatectomy (n = 1) Pancreatic resection was performed via laparoscopy in 7 patients who underwent distal pancreatectomy. Tumor resection was not performed in only 1 patient (5%), due to invasion of mesenteric vessels and presence of liver metastases. One patient had tumor rupture during laparoscopic resection, with no apparent macroscopic dissemination of the tumor. All 19 patients who underwent SPT resection had no tumor recurrence, including a patient with capsule invasion and another patient with tumor rupture during surgical dissection. The mean follow-up time was 38 months (range, 6–72 months).Conclusion:Complete SPT resection is possible in most patients, with a low recurrence rate. Because of its large size, laparoscopic resection of SPT's should be performed only by experienced surgeons to avoid tumor rupture.

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Section: Discussionmentioning

confidence: 55%

Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Coelho

Costa

Ramos

et al. 2018

JSLS

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“…Andronikou et al [27] reported a case of a 15-year-old female with peritoneal metastases from a pancreatic SPN, which had been excised 6 years previously. Kyokane et al [28] described a case of a 58-year-old female who underwent a distal pancreatectomy for a SPN, who developed peritoneal dissemination 6.5 years after surgery. Both of these cases had a previous history of rupture of SPN, as in the current patient, caused by either a spontaneous or traumatic mechanism prior to undergoing a radical excision of the tumor.…”

Section: Discussionmentioning

confidence: 98%

Peritoneal and nodal recurrence 7 years after the excision of a ruptured solid pseudopapillary neoplasm of the pancreas: report of a case

et al. 2012

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A solid pseudopapillary neoplasm (SPN) of the pancreas is generally regarded as a neoplasm of low malignant potential and there is rarely recurrence of the disease. A 12-year-old female underwent a pylorus preserving pancreaticoduodenectomy for a ruptured pancreatic SPN following a blunt abdominal trauma. The tumor showed no pathological features suggesting malignant potential. Follow-up imaging studies depicted small nodules adjacent to the superior mesenteric vein 7 years after surgery. A laparotomy was performed, and exploration revealed 3 nodules adjacent to the superior mesenteric vein and 4 small nodules in the mesointestine. All of these lesions were extirpated, and were histologically confirmed to be nodal and peritoneal recurrence of SPN. This case indicates that SPN of the pancreas has a latent ability to recur, regardless of its benign pathological features, and peritoneal spread may be promoted by trauma. A close postoperative follow-up is thus mandatory in all patients with SPN even after a radical resection.

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“…Kim reported that tumor rupture is a risk factor for SPN recurrence [ 24 ]. However, only 2 of the 12 patients with ruptured SPN had peritoneal metastasis with 27 months of follow-up data as described on the report by Kyokane [ 17 ]. Thus, whether the rupture is the real reason for peritoneal carcinomatosis is debatable [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Features and Treatment of Peritoneal Metastases from Solid Pseudopapillary Neoplasms of the Pancreas

Tian

Liu

et al. 2018

Med Sci Monit

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BackgroundSolid pseudopapillary neoplasms (SPNs) of the pancreas may present widespread peritoneal metastases, but the treatment of this malignancy has not been well described and requires further investigation.Material/MethodsFour cases of SPN with significant peritoneal metastases in our department were operated and retrospectively summarized after long-term follow-up. Eight more cases of peritoneal metastatic SPN from the PubMed database were also included in the analysis.ResultsPeritoneal metastases of SPNs have different gross features. The benign nodules were tenacious and well encapsulated, while the malignant nodules were soft and prone to slow bleeding. However, neither of these nodules invaded the small intestines or mesentery. Of the 12 disseminated cases, 7 had history of primary tumor rupture, whereas the others had tumors malignant in nature. A total of 14 surgical events were documented, including 3 complete cytoreductive surgeries (CCRS), 9 cytoreductive surgeries (CRS), and 2 debulking surgeries. After follow-up ranging from 0.3 to 6.1 years, the results of the Fisher’s exact test showed no difference between CCRS and CRS in treating either low-grade or high-grade malignant SPNs (P=0.257 and P=0.203, respectively). For all cases of SPN with peritoneal metastases, the CCRS procedure could significantly improve tumor-free survival (TFS) compared to the CRS procedure (P=0.046).ConclusionsSPN rupture could cause significant peritoneal metastases, and either disruption or biopsy of these lesions should be avoided. Peritoneal metastases from SPNs vary both in gross features and biological mechanisms. CCRS may offer optimal therapeutic outcomes and longer TFS for individuals with significant peritoneal metastases of SPNs.

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A Case of Successful Resection for Peritoneal Recurrence of Solid-pseudopapillary Tumor of the Pancreas Occurred in 6.5 Years after Rupture of the Tumor

Cited by 8 publications

References 10 publications

Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Peritoneal and nodal recurrence 7 years after the excision of a ruptured solid pseudopapillary neoplasm of the pancreas: report of a case

Features and Treatment of Peritoneal Metastases from Solid Pseudopapillary Neoplasms of the Pancreas

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