Solid pseudopapillary neoplasms of the pancreas

Česká verzia

Authors: J. Tesaříková ¹; M. Loveček ²; Č. Neoral ^1,2; K. Vomáčková ²; L. Bébarová ¹; P. Skalický ²
Authors place of work: I. chirurgická klinika FN Olomouc, přednosta: prof. MUDr. Č. Neoral, CSc. ¹; I. chirurgická klinika LF Univerzity Palackého, Olomouc, přednosta: prof. MUDr. Č. Neoral, CSc. ²
Published in the journal: Rozhl. Chir., 2017, roč. 96, č. 4, s. 163-167.
Category: Původní práce

Summary

Introduction:
Solid pseudopapillary neoplasm (SPN) is a very rare neoplasm that occurs in girls and young women in 90% of cases; the range is 7−79 years of age, and the median is 28 years of age. This tumour was first described by Virginia Frantz in 1959 as a papillary cystic tumour of the pancreas.

Methods:
The aim of this retrospective study was to analyse the incidence of SPN in all patients with a pancreatic tumour operated at the 1^st Dept. of Surgery, University Hospital Olomouc between years 2006 and 2015. Clinical symptoms, imaging methods used, tumour marker positivity, histological findings, postoperative complications and disease-free interval were all evaluated.

Results:
Of the 454 patients operated on between 2006−2015, the diagnosis of SPN was made in five female patients. The following imaging methods were used in the preoperative diagnostic process: CT, MRI, PET/CT and endosonography. In four patients the tumour was localised in the tail of the pancreas; these women underwent left-sided pancreatectomy. In one patient, the tumour was located in the pancreatic head and a pylorus-preserving pancreaticoduodenectomy was performed. Complications were seen only in one patient who underwent revision on the first postoperative day for bleeding from the pancreatic cut surface. Pancreatic fistula was not observed in any of the patients. The procedures were considered as sufficient from the oncological viewpoint due to the radical resection procedure and negative resection margin, and therefore no adjuvant oncological treatment was indicated in any of the patients. During the follow-up period, recurrence was not observed in any one of the patients.

Conclusion:
Solid pseudopapillary neoplasm of the pancreas is a rare disorder with a low malignant potential occurring primarily in young women. Generally, SPN has a good prognosis; however, advanced stages of the disease with distant metastases may be encountered in rare cases. The only curative treatment is radical surgical resection.

Key words:
solid pseudopapillary neoplasm − Frantz’s tumour − pancreas

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