Retrospective analysis of 102 cases of solid pseudopapillary neoplasm of the pancreas in China

Abstract

Surgical resection is the primary therapy for SPN, and results in a good prognosis.

Limited usefulness of histopathological features in identification of a clinically aggressive solid-pseudopapillary neoplasm of the pancreas

“…The limitation of our study is the relatively small number of examined cases, especially in comparison with recent large series from Asia [7,19,32,38,47].…”

“…We noted a single clinically aggressive SPN in the present series (5.9%). The percentage of cases with malignant features varies between studies, from less than 4% to more than 20% [5,19,33,35,38,49,53,85]. This may be related to differences in criteria of malignancy, follow-up protocols, adjuvant treatment, as well as patients' characteristics.…”

“…The clinical factors included: male gender [5,18,32], patient's age [5,18,[32][33][34], body mass index [18], serum tumour markers [18,33], presence of symptoms [18,32], mean duration of symptoms [18,32], non-resectability [35], extent of surgery [5,36], familial occurrence of tumour [37], and multiple primary lesions in a single patient [38,39]. Histopathological factors included: extrapancreatic localization of the main neoplastic mass [40,41], localization of tumour within particular segment of the pancreas [5,18,32], tumour diameter [5,32,42], gross characteristics of tumour (solid, cystic, or mixed) [18,32,43], tumour rupture [43][44][45], lack of a tumour capsule [46] and incomplete capsule [47], capsule invasion [17,18,33,48], invasion into pancreatic parenchyma [17,33,49] or adjacent tissues or organs (invasion of duodenum, spleen, common bile duct, peripancreatic fat) …”

Kikuchi disease: A case report about Sintilimab-induced Kikuchi histiocytic necrotizing lymphadenitis and literature review

“…Among them, cellular atypia, infiltration of pancreatic parenchyma and surrounding tissues, peripancreatic vascular invasion, and peripheral nerve infiltration are highly invasive pathological manifestations of SPN, and a number of studies have found that SPN has calcifications on imaging, lesions greater than 5 cm, incomplete tumor capsule, microvascular invasion, preoperative metastasis, non-radical resection, and high proliferation index. It may be a high risk factor for recurrence, but there is still no consistent conclusion on the risk factors related to postoperative recurrence and poor prognosis, and there is no evidence that postoperative adjuvant chemotherapy has a positive impact on the prognosis of SPN [ [30] , [31] , 32 ]. Because the clinical cases of invasive SPN are very rare, it is difficult to summarize and clarify the natural course of invasive SPN in clinical situations, which makes it difficult for clinicians or surgeons to provide patients and their families with information about invasive pancreatic SPN [ 33 ].…”

Massive extrapancreatic solid pseudopapillary neoplasm misdiagnosed as hepatic tumor: a case report and literature review

“…Noteworthily, the majority of SPNPs have been described as benign in nature; nonetheless, 10-15% of SPNPs exhibit malignant behavior and metastases ( 18 ). Surgery remains the current preferred treatment option for SPNP ( 2 – 4 , 6 , 19 ), and the surgical approach largely depends on the location, size, and nature of the tumor. Commonly employed surgical procedures include distal pancreatectomy, central pancreatectomy, total pancreatectomy, pancreaticoduodenectomy, etc.…”