Solid pseudopapillary neoplasms of the pancreas
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:
Original articles
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 1st 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
Zdroje
1. Frantz VK. Tumors of the pancreas. In: Bumberg CW, editors. Atlas of tumor pathology, VII. Fascicles 27 and 28, Washington, DC, Armed Forced Institute of Pathology 1959:32−3.
2. Klöppel G, Solcia E, Longnecker DS, et al. Histological typing of tumor of the exocrine pancreas. In: World Health Organisation international histological classification of tumors. 2nd ed. Berlin, Heidelberg, New York, Springer 1996:8452/1.
3. Klöppel G, Hruban RH. Solid-pseudopapillary tumor of pancreas. World Health Organization classification of tumors of the digestive system. Lyon, IARC 2010:327−30.
4. Morohoshi T, Held G, Kloppel G. Exocrine pancreatic tumours and their histological classification. A study based on 167 autopsy and 97 surgical cases. Histopathology 1983;7:645−61.
5. Lüttges J. Was ist neu?, Die WHO-Klassifikation 2010 für Tumoren des Pankreas, Der Pathologe 2011;32:332.
6. Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in the English literature. J Am Coll Surg 2005;2:965−72.
7. Law JK, Ahmed A, Singh VK, et al. A systematic review of solid pseudopapillary neoplasms: Are these rare lesions? Pancreas 2014;43:331–7.
8. Gürlich R, Kment M, Novotný J, et al. Solidní pseudopapilární tumor pankreatu. Bulletin HPB Chirurgie 2007;1: 2–5.
9. Brázdil J, Hermanová M, Křen L, et al. Solidní pseudopapilární tumor pankreatu: soubor pěti případů. Rozh Chir 2004;83: 73–8.
10. Igbinosa O. Pseudopapillary tumor of the pancreas. An algorithmic approach. JOP. 2011;12:262–5.
11. Mirminachi B, Farrokhzad S, Sharifi AH, et al. Solid pseudopapillary neoplasm of pancreas; A case series and review literature. Middle East J Dig Dis 2016;8:102–8.
12. Yin Q, Wang M, Wang C, et al. Differentiation between benign and malignant solid pseudopapillary tumor of the pancreas by MDCT. Eur J Radiol 2012;81:3010−8.
13. Igbinosa O. Pseudopapillary tumor of the pancreas: An algorithmic approach. JOP 2011;12:262−5.
14. Yu PF, Hu ZH, Wang XB, et al. Solid pseudopapillary tumor of the pancreas: a review of 553 cases in Chinese literature. World J Gastroenterol 2010;16:1209−14.
15. Xiaolong Tang, Jianwei Zhang, Xu Che, et al. Peripancreatic lymphadenopathy on preoperative radiologic images predicts malignancy in pancreatic solid pseudopapillary neoplasm. Int J Clin Exp Med 2015;8:16315−21.
16. Washington K. Solid-pseudopapillary tumor of the pancreas: challenges presented by an unusual pancreatic neoplasm. Ann Surg Oncol 2002;9:3−4.
17. Jarboui S, Daghfous A., Kacem K, et al. Solid-pseudopapillary tumor of the pancreas: Clinical and radiological features. Case Reports in Clinical Medicine 2013;2:415−21.
18. Frago R, Fabregat J, Jorba R, et al. Solid pseudopapillary tumors of the pancreas: Diagnosis and curative treatment. Revista Espanola de Enfermedades Digestivas 2006;98:809−16.
19. Miao F, Zhan Y, Wang XY, et al. CT manifestations and features of solid cystic tumors of the pancreas. Hepatobiliary Pancreat Dis Int 2002;1:465−8.
20. Ventriglia A, Manfredi R, Mehrabi S, et al. MRI features of solid pseudopapillary neoplasm of the pancreas. Abdominal Imaging December 2014;39:1213–20.
21. Virgilio E, Mercantini P, Ferri M, et al. Is EUS-FNA of solid-pseudopapillary neoplasms of the pancreas as a preoperative procedure really necessary and free of acceptable risks? Pancreatology. 2014;14:536−8.
22. Kosmahl M, Seada LS. Solid-pseudopapillary tumor of the pancreas: its origin revisited. Virchows Arch. 2000;436:473−80.
23. Cai Y, Ran X, Xie S, et al. Surgical management and long-term follow-up of solid pseudopapillary tumor of pancreas: a large series from a single institution. J Gastrointest Surg 2014;18:935−40.
24. Cai Y, Ran X, Xie S, et al. Surgical management and long-term follow-up of solid pseudopapillary tumor of pancreas: a large series from a single institution. J Gastrointest Surg 2014;18:935−40.
25. Cheng K, Shen B, Peng C, et al. Synchronous portal-superior mesenteric vein or adjacent organ resection for solid pseudopapillary neoplasms of the pancreas: a single-institution experience. Am Surg. 2013;79:534−9.
26. Martin RC, Klimstra DS, Brennan MF, et al. Solid pseudopapillary tumor of the pancreas: a surgical enigma? Ann Surg Oncol 2002;9:35−40.
27. Mao C, Guvendi M, Domenico DR, et al: Papillary cyst and solid tumors of the pancreas: a pancreatic embryonic tumor? Studies of three cases and cumulative review of the world´s literature. Surgery. 1995;118:821–8.
28. Paik WH, Seo DW, Dhir V, et al. Safety and efficacy of EUS-guided ethanol ablation for treating small solid pancreatic neoplasm. Medicine (Baltimore) 2016;95:2538.
29. Gaiguo Dai, Ling Huang, Yian Du, et al. Solid pseudopapillary neoplasms of the pancreas: clinical analysis of 45 cases. Int J Clin Exp Pathol 2015;8:11400−6.
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