Predicting Recurrence of Pancreatic Solid Pseudopapillary Tumors After Surgical Resection

Kang, Chang Moo; Choi, Sung Hoon; Kim, Song Cheol; Lee, Woo Jung; Choi, Dong Wook; Kim, Sun Whe

doi:10.1097/sla.0000000000000583

Cited by 120 publications

(158 citation statements)

References 29 publications

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“…Few previous studies of SPPN have separately analyzed adults and children . The main features of SPPN in children are a higher frequency of abdominal pain and fewer incidental diagnoses (22%) . An exhaustive review of the literature shows that SPPN is equally distributed in the head, body, and tail of the pancreas and have a mean size of 7 cm (Supplementary Table SI).…”

Section: Discussionmentioning

confidence: 93%

“…Seven patients (13.7%) relapsed, a median of 43 months after initial surgery. [–94] One patient experienced two relapses at a 10.6‐month interval. During a median follow‐up of 65 months [0.3–221], recurrences were found in five patients by routine follow‐up imaging (Computed tomography CT or Magnetic Resonance Imaging MRI), by the occurrence of hypogastric pain in one patient, and by self‐examination (mass) in one patient.…”

Section: Resultsmentioning

confidence: 99%

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Recurrence of Solid Pseudopapillary Neoplasms of the Pancreas: Results of a Nationwide Study of Risk Factors and Treatment Modalities

Irtan

Galmiche-Rolland

Elie³

et al. 2016

Pediatric Blood & Cancer

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Background Solid pseudopapillary neoplasms of the pancreas (SPPN) can relapse very late, but little is known about risk factors for recurrence and optimal treatment. We aimed to identify risk factors for recurrence and to analyze treatment modalities in all French pediatric cases of SPPN over the past 20 years. Material and methods Data were collected from pediatric oncologists and surgeons, and also from adult pancreatic surgeons in order to identify late recurrences. Results Fifty‐one patients (41 girls) were identified. Median age at diagnosis was 13.1 years [8.7–17.9]. Abdominal pain was the commonest presenting symptom (32/49, 65%). The tumor was located in the pancreatic head in 24 patients (47%). Preoperative biopsy or cytology was performed in 14 cases (28%). All patients were operated with a median of 23 days [0–163] after diagnosis. The rate of postoperative morbidity was 29%. With a median follow‐up of 65 months [0.3–221], the overall and event‐free survival was 100% and 71%, respectively. Seven patients (13.7%) relapsed with a median of 43 months [33–94] after initial surgery. Six were treated surgically, either alone (n = 3) or with perioperative chemotherapy (n = 2) or hyperthermic intraperitoneal chemotherapy (n = 1). One patient in whom further treatment was not feasible was still alive at last news. Risk factors for recurrence were positive surgical margins (P = 0.03) and age less than 13.5 years at diagnosis (P = 0.03). Conclusions SPPN recurrence in this pediatric series was a rare and late event that did not undermine overall survival. Complete surgical removal of recurrent tumors appears to be the best option.

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Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Recurrence of Solid Pseudopapillary Neoplasms of the Pancreas: Results of a Nationwide Study of Risk Factors and Treatment Modalities

Irtan

Galmiche-Rolland

Elie³

et al. 2016

Pediatric Blood & Cancer

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“…Outpatient records combined with telephone interviews were used for follow-up. The criteria of SPN were defined as malignant if it demonstrated extrapancreatic invasion, distant metastases, pancreatic parenchymal invasion, peripancreatic fat tissue infiltration, lymph node involvement, capsular invasion, or perineural or vascular invasion [4–7]. Patient status was due to the time of last follow-up as follows: no evidence of disease, alive with disease, dead of disease, surgical mortality, and dead of other causes.…”

Section: Methodsmentioning

confidence: 99%

Solid Pseudopapillary Neoplasm of the Pancreas: Clinicopathologic Feature, Risk Factors of Malignancy, and Survival Analysis of 53 Cases from a Single Center

Dong

Zhou

et al. 2017

BioMed Research International

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Introduction Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor of low malignant potential. The aim of this study was designed to evaluate the clinicopathologic feature, predictive factors of malignancy, and survival from experience of a single center. Methods 53 consecutive patients who underwent surgery for a pathologically definitive SPN were retrospectively reviewed. Results A total of 53 cases included 7 male cases and 46 female cases with the median age of 35.4 years (14–67). Abdominal pain and mass were the most common clinical presentations. The radiological presentations were consistent with solid and cystic pattern in 18 cases, solid pattern in 25 cases, and cystic pattern in 10 cases. The predominant location of tumor was pancreatic body and tail. The mean size of the tumors was 6.4 cm. Aggressive en bloc resection combined with organ-preserving should be indicated whenever feasible. Follow-up information was available for 48 patients with a median follow-up time of 48 months. The 5-year disease-specific survival was 95.7%. Incomplete capsule was not only the predictive factor of malignancy but also the significant predictor of disease-specific survival. Conclusion Incomplete capsule may suggest a malignant SPN and a prognostic indicator of disease-specific survival. We recommend that surgeons consider a more radical resection with an incomplete capsule of tumor.

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“…Solid pseudopapillary tumors of the pancreas affect primarily young women, suggesting that hormonal factors contribute to the tumor growth [4,5,8]. In the current study, symptoms were reported at a woman of 28 years of age, an age at which female hormones and their receptors such as progesterone, estrogen are very active and might play a role in the development of solid pseudopapillary tumor of the pancreas [9,10].…”

Section: Discussionmentioning

confidence: 99%

CCK-2/Gastrin-R Immunodistribution in a Solid Pseudopapillary Pancreatic Tumor: A Case Report of a 28-Years-Old North African Woman

Harir¹

2016

Glob J Medical Clin Case Rep

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The presence of a large bulky pancreatic tumour in a young female should raise suspicions of the diagnosis of solid-pseduopapillary tumour of the pancreas.Solid pseudopapillary neoplasms of the pancreas are uncommon, accounting for only 1-2% of all pancreatic neoplasms. These tumors are being detected at an increased rate, probably due to the increased awareness and the liberal use of imaging.We report a case of a 28-year-old North African woman with no prior medical or surgical history diagnosed with solid pseudopapillary pancreatic tumor. Our immunohistochemical study demonstrated that the tumor cells were positive for CCK-2/gastrin receptors and that were highly expressed within the cytoplasmic area of the cells. Hence we attempted to raise a hypothesis and to establish a link between some female hormones which represents powerful regulators of the expression of CCK and their possible impact on the development of solid pseudopapillary pancreatic tumours in young women.were unremarkable. Laboratory data including hematology, blood chemistry including amylase and lipase, as well as tumor markers were within the reference limits (CEA = 0.692 ng/ml, CA 125 = 12.27 Ul/ml, and CA 19-9 = 22.59 Ul/ml).Ultrasound imaging (Figure 1) showed a solid heterogeneous mass at the level of left quadrant measuring 124 mm.CT scan of the abdomen ( Figure 2) revealed a voluminous hypoattenuating mass in the tail and the body of the pancreas, measuring 127mm x 87mm with multiple intratumoral vessels.After a surgical biopsy was performed; histological examination demonstrated a solid pattern with non infiltrant pseudopapillary cores; the tumor was found to be confined to the pancreas ( Figure 3). Our immunohistochemical analysis revealed that the tumor cells IntroductionSolid Pseudopapillary Tumor (SPT) of the pancreas is a very rare entity with a reported incidence of 0.13% to 2.7% of all pancreatic tumors [1], this tumor was once described in many other terms, such as Frantz's tumor, solid and cystic tumor, papillary cystic neoplasm, and solid and papillary epithelial neoplasm [2].It is almost exclusively seen in females and occurs in the second or third decades of life [3], suggesting that this tumor is associated with some female hormones and their receptors such as estrogen, progesterone and opioids [4,5]. Several lines of evidence support the role of G protein-coupled receptor cholecystokinin 2 and gastrin (CCK-2R/gastrin-R) in pancreatic cancer development [6,7].In order to study immunohistochemical features of G protein coupled CCK2/gatrin receptors in this kind of rare tumors, we herein present a case of solid pseudopapillary pancreatic tumor associated with a positive CCK-2/gastrin-R reactivity. Case ReportA 28-year-old North African woman with no prior medical or surgical history presented with complaints of epigastric and right upper quadrant (RUQ) pain and decreased appetite during one month. Her pulse rate was 72 min-1 and her blood pressure was 110/60 mmHg. There was no precipitating or aggravating factor and...

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Predicting Recurrence of Pancreatic Solid Pseudopapillary Tumors After Surgical Resection

Cited by 120 publications

References 29 publications

Recurrence of Solid Pseudopapillary Neoplasms of the Pancreas: Results of a Nationwide Study of Risk Factors and Treatment Modalities

Recurrence of Solid Pseudopapillary Neoplasms of the Pancreas: Results of a Nationwide Study of Risk Factors and Treatment Modalities

Solid Pseudopapillary Neoplasm of the Pancreas: Clinicopathologic Feature, Risk Factors of Malignancy, and Survival Analysis of 53 Cases from a Single Center

CCK-2/Gastrin-R Immunodistribution in a Solid Pseudopapillary Pancreatic Tumor: A Case Report of a 28-Years-Old North African Woman

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