Solid pseudopapillary tumor of the pancreas: clinical-pathological features and management of 13 cases

Abstract

Background and aimSolid pseudopapillary tumor (SPT) of the pancreas is a rare pathological condition, representing less than 3% of all exocrine pancreatic tumors. SPT usually occurs in young females, without notable symptoms, with a low malignant potential and excellent prognosis.MethodWe conducted a retrospective study during the period January 2005 – January 2015. SPT patients admitted in our institution were reviewed by describing demographic data, clinico-pathologic and radiological features, therapeutic management and prognosis records.ResultsThirteen patients with SPT were identified (10 females), with a median age of 30 years. The main clinical presentation was abdominal pain (92.3%). The tumor was mostly located in the body or tail of the pancreas (77%), and the mean size was 8.2 cm. Regarding the surgical approach there were 5 distal pancreatectomies with splenectomy, 3 body and tail pancreatectomies, 2 body and tail pancreatectomies with splenectomy, 2 pancreato-duodenectomy, 1 partial enucleation and of all only 2 partial resections. Postoperative hematoxylin- eosin staining and immunohistochemistry confirmed the diagnosis in all cases. None of the patients had lymph nodes metastases. Only one local invasion. There was one case of death due to postoperative complications. Four cases followed adjuvant systemic chemotherapy. The mean follow-up was 18 months, without evidence of recurrence during this period.ConclusionSPT should always be considered in the differential diagnosis in young women with a pancreatic tumor. Complete surgical excision is the treatment of choice, and is usually curative. The decision to administer systemic therapy must be individualized. Malignant behavior and late recurrences mandates long-term follow-up for patients with SPT.

Laparoscopic enucleation of Frantz's tumor of the pancreas: Case report and literature review

“…These tumors most commonly remain asymptomatic or cause non-specific complaints, regardless of their size. In addition to the compressive effect on the surrounding structures and the occurrence of a palpable mass in the abdomen once they reach a specific size, occasional acute or chronic pain, loss of appetite, vomiting, and a loss in body mass, may also occur [ 9 ].…”

Atypical solid pseudopapillary tumor of the pancreas in a 14‐year‐old

“…[2][3][4] It does not have a typical clinical presentation. 5 The symptoms are nonspecific ranging from pruritus to acute or chronic abdominal pain; it can also be an incidental finding on radiological examination. 6 In our case, it was discovered through exploration of a chronic diarrhea and obstructive pancreatic head mass.…”

“…SPT is most common in adult women 2–4 . It does not have a typical clinical presentation 5 . The symptoms are nonspecific ranging from pruritus to acute or chronic abdominal pain; it can also be an incidental finding on radiological examination 6 .…”

Solid pseudopapillary neoplasm of the pancreas in children: Hacettepe experience

“…For tumours located in the body and tail, distal pancreatectomy is recommended. Tumour size has not been reported to be a contraindication for surgery because large tumours can also be resected with safe margins . Laparoscopic resections and enucleations of SPNP have also been reported to be safe and provide adequate resection margins .…”