Solid Pseudopapillary Tumors of the Pancreas: Mayo Clinic 20 Years' Experience

Abstract

Introduction: Solid pseudopapillary tumor (SPT) of the pancreas is a rare female predominant pancreatic neoplasm with favorable prognosis. Complete tumor removal is usually curative, and recurrences or mortalities are uncommon. This study aimed to present Mayo clinic experience with SPT in a 20-year cohort emphasizing clinical presentations, pathological features and predictors of outcomes. This is one of the largest single institution cohorts to be published for SPT. Method: Individuals undergoing Pancreatectomies for SPT at Mayo Clinic between 01/2000 and 12/2020 were identified via electronic institutional databases. Demographic, clinical, operative and postoperative details as well as recurrence and survival patterns were abstracted and retrospectively analyzed. Results: 51 patients had Pancreatectomies for SPT during the time period, 46(90.2%) were women and the median age was 28 years. The most common presenting symptom was abdominal pain in 26(51%) patients. Tumor location within the pancreas spread equally between the head/body/tail and the median tumor size was 4.1 centimeters. 29(57%) patients had distal/subtotal Pancreatectomy, 16(31%) Whipple procedure, 3(6%) central Pancreatectomy, 2(4%) enucleations and 1(2%) total Pancreatectomy. With a median follow-up of 5.8 years, 5(9.8%) patients had recurrence and there was no tumor related mortality. Potential malignant features such as local invasion/vascular involvement/positive lymph nodes/perineural invasion were found in 11(22%) patients. Positive resection margins and adjacent organ invasion were significantly associated with tumor recurrence (P=0.003 and P<0.001 respectively). Conclusions: SPT is a rare pancreatic neoplasm with favorable prognosis. Positive resection margins and adjacent organ invasion are associated with recurrences and these patients should be followed closely.