Safety of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Pancreatic Solid Pseudopapillary Neoplasm Before Surgical Resection

Karsenti, David; Caillol, Fabrice; Chaput, Ulriikka; Perrot, Bastien; Koch, Stéphane; Vuitton, Lucine; Jacques, Jérémie; Valats, Jean-Christophe; Poincloux, Laurent; Subtil, C.; Chabrun, Edouard; Williet, Nicolas; Vanbiervliet, Geoffroy; Belkhodja, Hichem; Charachon, Antoine; Wangermez, Marc; Coron, Emmanuel; Cholet, Franck; Privat, Jocelyn; Baleur, Yann Le; Bichard, Philippe; Soune, Philippe Ah; Lecleire, Stéphane; Palazzo, Maxime

doi:10.1097/mpa.0000000000001460

Cited by 22 publications

(16 citation statements)

References 18 publications

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“…The application of endoscopic ultrasound (EUS) maybe a better solution. Preoperative EUS and EUS guided tissue acquisition allowed pancreatic SPN diagnosis in 80%-90 cases (24,25). Moreover, the Ki67 index can be measured by the specimens obtained by EUS guided tissue biopsy (26).…”

Section: Discussionmentioning

confidence: 99%

The Sex Features of Patients With Solid Pseudopapillary Neoplasms of the Pancreas: A Retrospective Study

et al. 2022

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BackgroundSolid pseudopapillary neoplasms of the pancreas (SPNs) in male patients are more frequently reported. The aim of the study was to evaluate the sex features of SPN and the risk factors that predict tumor recurrence.MethodsFrom 2013 to 2019, patients who were pathologically confirmed to have SPNs were retrospectively reviewed. The baseline study parameters were compared between males and females. A logistic regression model was established to identify the independent risk factors for tumor recurrence.ResultsIn total, 221 patients were included in this study. Of them, 53 patients (24.0%) were males. Male patients were older than female patients (39.1 vs 31.6 years, P=0.001), and the tumor size in male patients was smaller than that in female patients (50.38 vs 39.65 mm, P=0.038). The preoperative imaging diagnostic accuracy was significantly higher in females than in males (70.5% vs 54%, P=0.02). SPNs in male patients tended to be misdiagnosed with other malignant tumors (37.7% vs 10.7%, P<0.0001), with a more solid component observed in images (66.8% vs 24.7%, P<0.0001). For immunohistochemical staining, the expression of beta catenin was significantly lower in male patients (P=0.002), and the expression of vimentin was the opposite (P=0.01). The overall survival rate and disease-free survival were not different. Based on multivariate analysis, older age [hazard ratio (HR)= 1.094, 95% confidence interval (CI): 1.005-1.190] and KI 67 index grade III (HR=12.029, 95% CI: 2.399-60.311) were independent risk factors for tumor recurrence.ConclusionThe clinical and imaging features of SPN in males were not in full accord with those in females; however, the differences did not influence prognosis.

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Section: Discussionmentioning

confidence: 99%

The Sex Features of Patients With Solid Pseudopapillary Neoplasms of the Pancreas: A Retrospective Study

et al. 2022

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“…However, although SPNs often contain cystic components, EUS-FNA for cystic tumors is controversial in terms of safety. A multicenter study of FNA procedures in Europe by Karsenti et al [ 16 ] that evaluated the risk of tumor dissemination suggested that there was no recurrence or dissemination after surgery. On the other hand, Yamaguchi et al [ 17 ] reported the world’s first case of dissemination after EUS-FNA for SPN.…”

Section: Discussionmentioning

confidence: 99%

Solid pseudopapillary neoplasm of the pancreas in a young male with main pancreatic duct dilatation: A case report

Nakashima¹,

Satô²,

Imamura³

et al. 2021

WJCC

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BACKGROUND Solid pseudopapillary neoplasms (SPNs) are rare tumors of the pancreas. Typically, they occur in young females, often have characteristic imaging features, such as cystic components and calcification, and have few effects on the pancreatic duct. CASE SUMMARY A 31-year-old man was admitted to our hospital with the chief complaint of epigastric pain. There was only mild tenderness in his upper abdomen, and blood tests showed only a slight increase in alkaline phosphatase. Contrast-enhanced computed tomography showed a 40-mm-diameter, hypovascular mass in the head of the pancreas, and the main pancreatic duct upstream of the mass was severely dilated. Magnetic resonance imaging showed low intensity on T1-weighted images, with high intensity on T2-weighted image in some parts. Pancreatic ductal adenocarcinoma was the primary differential diagnosis. Portal vein infiltration could not be ruled out, so this case was a candidate for neoadjuvant chemotherapy. Subsequently, endoscopic ultrasound-guided fine needle aspiration was performed, and pathological evaluation and immunostaining suggested a diagnosis of SPN. Thus, pancreatoduodenectomy was performed. One year after the operation, the patient is alive with no recurrence. CONCLUSION Main pancreatic duct dilatation is usually a finding of suspected pancreatic cancer. However, pancreatic duct dilatation can occur in SPN depending on the location and growth speed. Therefore, SPN should be considered in the differential diagnosis of tumors with pancreatic duct dilatation, and pathological evaluation by endoscopic ultrasound-guided fine needle aspiration should be actively performed.

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“…Furthermore, older age is an independent risk factor for recurrence[ 21 ] and is significantly associated with tumor recurrence[ 22 ]. In addition, as there are no significant differences in margin status, peripheral tissue invasion, postoperative complications, disease-free survival, or overall survival between male and female patients, the prognosis of SPNs has been reported to be similar between male and female patients[ 21 ].…”

Section: Precautions Of and Relevant Suggestions For Enucleation Appl...mentioning

confidence: 99%

Prospects and applications of enucleation in solid pseudopapillary neoplasms of the pancreas

Wang¹,

Li²,

Tan³

et al. 2022

WJGO

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Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare, low-grade, malignant neoplasms that are mostly seen in young women in the second and third decades of life and are quite uncommon in children. Standard resection for benign and borderline neoplasms of the pancreas is associated with a substantial risk of postoperative morbidity and long-term functional impairment, whereas enucleation leads to less morbidity and preserves healthy parenchyma as well as exocrine and endocrine function. Enucleation of SPNs has been increasingly reported to be feasible and safe for preserving the normal physiological function of the pancreas, especially in teenagers and children. This review summarizes findings published in recent years on the enucleation of SPNs as well as potential future developments and directions. Enucleation has undoubtedly come to stay as an alternative surgical procedure for SPNs. However, many questions remain unresolved, and future directions toward the best surgical indication, the prevention and intervention of complications, especially pancreatic fistula, intraoperative resection margin safety assessment, and long-term oncology prognosis remain to be evaluated and should be explored in future clinical trials.

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Safety of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Pancreatic Solid Pseudopapillary Neoplasm Before Surgical Resection

Cited by 22 publications

References 18 publications

The Sex Features of Patients With Solid Pseudopapillary Neoplasms of the Pancreas: A Retrospective Study

The Sex Features of Patients With Solid Pseudopapillary Neoplasms of the Pancreas: A Retrospective Study

Solid pseudopapillary neoplasm of the pancreas in a young male with main pancreatic duct dilatation: A case report

Prospects and applications of enucleation in solid pseudopapillary neoplasms of the pancreas

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