Abstract
ABSTRACT Background: Solid pseudopapillary tumor of the pancreas is a rare low-grade malignant neoplasm. Most patients present with nonspecific symptoms until the tumor becomes large. Complete surgical resection by pancreatoduodenectomy is the treatment of choice for tumors located in the head of the pancreas Aim: To analyzed the clinicopathologic features, management, and outcomes of patients who had solid pseudopapillary tumor of the head pancreas and underwent surgical resection. Methods: Were analyzed 16 patients who underwent pancreatoduodenectomy for this condition. Results: Mean age was 25.7 years old, and 15 patients were female (93.7%). Nonspecific abdominal pain was present in 14 (87.5%). All underwent computed tomography and/or magnetic resonance imaging as part of diagnostic workup. The median diameter of the tumor was 6.28 cm, and surgical resection was performed with open or laparoscopic pancreatoduodenectomy without neoadjuvant chemotherapy. Postoperative complications occurred in six patients (37.5%) and included pancreatic fistula without mortality. The mean of hospital stay was 10.3 days. Median follow-up was 3.6 years, and no patient had local recurrence or metastatic disease. Conclusion: For these patients surgical resection with pancreatoduodenectomy is the treatment of choice showing low morbidity, no mortality, and good long-term survival.
Highlights
Solid pseudopapillary tumor (SPT) of the pancreas, first described by Virginia K
More than 90% of patients are young females, suggesting some association with female hormones. This tumor accounts for approximately 1-2.5% of all exocrine pancreatic neoplasms, and most are large tumors that are confined to the pancreas, located in the head (26-34%) and the body and tail of the pancreas (66-74%)[11,15,16]
The risk of metastasis to the liver and peritoneum is low (10–15%), and long-term survival has been reported after surgical resection[9,14]
Summary
Solid pseudopapillary tumor (SPT) of the pancreas, first described by Virginia K. Frantz in 1959, is a rare, low-grade malignant tumor of the exocrine pancreas. More than 90% of patients are young females, suggesting some association with female hormones. This tumor accounts for approximately 1-2.5% of all exocrine pancreatic neoplasms, and most are large tumors that are confined to the pancreas, located in the head (26-34%) and the body and tail of the pancreas (66-74%)[11,15,16]. The World Health Organization (2010) defined the tumor as an epithelial low-grade malignant neoplasm with a gross pseudopapillary appearance and a cystic microscopic appearance. Tumors located in the pancreatic head are more likely to cause symptoms, even if they are small. Hemoperitoneum secondary to rupture of the tumor may occur as an emergency situation[5,7,20]
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