Solid Pseudopapillary Tumor Research Articles

Complications after pylori-preserving pancreatoduodenal resection in a 14-year-old girl with a solid pseudopapillary tumor of the pancreas

Pancreatoduodenal resection (PDR) is one of the most difficult surgical interventions in abdominal surgery of childhood. We present our clinical observation of a postoperative complication in a 14-years-old girl.The girl was operated on for a solid pseudopapillary tumor of the head of the pancreas, laparoscopically assisted pylori-preserving PDR was performed, mobilization and removal of the tumor was performed, distally between the stump of the pancreas and the Roux-en-Y loop of pancreatoejunoanastomo was formed. Mechanical jaundice occurred in the late postoperative period. Percutaneous transhepatic cholangiostomy, recanalization of hepaticoejunoanastomosis with the formation of external-internal transhepatic drainage was performed. 5 courses of balloon dilation of the stricture of the biliodigestive anastomosis were performed later.We demonstrate some complications of PDR in children and show possible options for their correction.

Gastrointestinal: Solid pseudopapillary neoplasm of the pancreas with high-grade malignant transformation.

Gastrointestinal: Solid pseudopapillary neoplasm of the pancreas with high-grade malignant transformation.

High-grade Solid Pseudopapillary Neoplasms of the Pancreas: Distinct Clinicopathological Malignant Features With Intriguing Gene Alterations through a Comparison With the Conventional Type.

Pancreatic solid pseudopapillary neoplasm (SPN) is a low-grade malignant neoplasm with a good prognosis. Clinically aggressive SPNs have rarely been reported but have not been analyzed in detail. In this study, we referred to this highly malignant type of SPN as high-grade SPN (HG-SPN) and compared its clinicopathological and genetic characteristics with conventional SPN (C-SPN) using immunohistochemistry and gene panel analyses. Five HG-SPNs and 15 C-SPNs were evaluated in this study. HG-SPNs share many pathologic characteristics: macroscopically, solid/cystic appearances, microscopically, pseudopapillary/pseudorosette pattern (100%), tumor cell loose cohesiveness (100%), thin/delicate vasculature (100%), tumor cell cytoplasmic vacuolization (100%), immunohistochemical positivity for β-catenin (nuclear expression) (100%), CD10 (80%), CD56 (80%), and vimentin (100%). Conversely, HG-SPNs showed distinct malignant features compared with C-SPNs: mean tumor size (11.7 vs. 2.9 cm, P <0.001); true necrosis (100% vs. 0%, P <0.001); high-grade nuclear atypia (100% vs. 0%, P <0.001); lymphatic and/or venous invasion (100% vs. 20%, P =0.004); mean mitotic count (4.38 vs. 0.05/high-power field, P <0.001); and mean Ki-67 labeling index (33.9% vs. 3.4%, P <0.001). All HG-SPN patients died of primary disease 3 to 36 months after surgery, while all C-SPN patients were alive without disease. Genetic studies have shown that all analyzed HG-SPNs have CTNNB1 mutations. Two HG-SPN cases showed RB1 mutations with altered immunohistochemical findings for RB1 and p16. Two HG-SPN cases had TP53 mutation and/or p53 overexpression. In conclusion, HG-SPNs show distinct malignant features and some genetic alterations that differ from C-SPNs, indicating the importance of differentiating between these 2 subtypes.

The World Health Organization Reporting System for Pancreaticobiliary Cytopathology.

The World Health Organization (WHO) Reporting System for Pancreaticobiliary Cytopathology (WHO System) is the product of a joint venture between the World Health Organization, the International Academy of Cytology, and the International Agency for Research on Cancer. The WHO System revises the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSC System) and replaces the 6-tiered system with a 7-tiered system. To explain the WHO System and the differences with the PSC System. The WHO System and the PSC System of Reporting Pancreaticobiliary Cytopathology. The diagnostic categories of the WHO System are "Insufficient/Inadequate/Nondiagnostic"; "Benign (Negative for Malignancy"'; "Atypical"; "Pancreaticobiliary Neoplasm, Low Risk/Low Grade (PaN-Low)"; "Pancreatic Neoplasm, High Risk/High Grade (PaN-High)"; "Suspicious for Malignancy"; and "Malignant." In the WHO System, the "benign" category includes both nonneoplastic and neoplastic lesions, so the "Neoplastic: Benign" category of the PSC system has been eliminated. Low-grade malignancies, pancreatic neuroendocrine tumors (PanNETs), and solid-pseudopapillary neoplasm (SPN) classified as "Neoplastic: Other" in the PSC System are classified as "Malignant" in the WHO System, leaving in the "Neoplasm" category intraductal lesions, which are divided into 2 new diagnostic categories: "Pancreaticobiliary Neoplasm (PaN)-Low Risk/Grade" and "PaN-High Risk/Grade." As with the PSC System, the WHO System advocates close correlation with imaging and encourages incorporation of ancillary testing into the final diagnosis, such as biochemical (carcinoembryonic antigen [CEA] and amylase) and molecular testing. The WHO System includes risk of malignancy per category, and reporting and diagnostic management options that recognize the variations in resources of low- and middle-income countries.

EUS-guided tissue acquisition in patients with solid pseudopapillary neoplasms of the pancreas

ABSTRACT Objectives Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has been the most common method used for the preoperative cytopathological diagnosis of solid tumors of the pancreas. There are only a few reported cases about the role of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in the pre-operative diagnosis of solid pseudopapillary neoplasms (SPN). This study aimed to evaluate the diagnostic yield of EUS-TA,including endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) andEUS-FNB, in patients with SPN. Methods We performed a retrospective analysis of patients with EUS-TA for SPN diagnosis in 2 referral centers. The primary outcome was the diagnostic yield of EUS-TA compared to the surgical specimen. Results Seventy-four patients with SPN of the pancreas were identified. Eighteen had a EUS-TA (10 EUS-FNB and 8 EUS-FNA). The median age of the patients was 31 years (IQR 21–38), and all patients were women. The most common presenting symptom was abdominal pain. Most of the tumors were in the head of the pancreas (9/18; 50%). The median tumor size by EUS was 4.5 cm (min-max 2–15 cm). The most common appearance on EUS was a solid lesion (n = 8/18, 44.4%). A definitive presurgical cytopathological diagnosis was obtained in 16/18 patients (88.8%) with EUS-TA. The sensitivity and positive predictive value of the EUS-TA were 94% each. One patient in the EUS-FNB group developed mild acute pancreatitis. Conclusion The diagnostic yield of the EUS-TA in SPN is high. In most cases, the diagnosis was obtained with the first procedure. No differences in the diagnostic yield or AEs between EUS-FNA vs. EUS-FNB needles were seen.

Solid pseudopapillary neoplasm of the pancreas with hepatic metastases: problems and strategies.

Solid pseudopapillary neoplasms of the pancreas with hepatic metastases are infrequent and difficult to diagnose, and treatment is uncertain. A retrospective analysis of clinical data from patients with pancreatic solid pseudopapillary neoplasm (SPN) hepatic metastases who underwent surgery at the First Hospital of Jilin University from January 2005 to December 2021 was conducted. A total of 287 patients with SPN were included in the study, of which 8 (3%) developed liver metastases, all of whom were treated surgically and recovered well after surgery. The clinical presentation, imaging features, surgical treatment, histopathological examination, and postoperative follow-up data (mean 70 months; range 28-138 months) of the patients were recorded and analyzed. Clinical response strategies can be derived by reviewing previous studies on hepatic metastases of SPNs. For resectable hepatic metastases from pancreatic solid pseudopapillary neoplasms, early surgery with total resection of the primary tumor and metastasis has shown great efficiency and is associated with patient good prognosis. In patients presenting unresectable hepatic metastases, aggressive tumor reduction surgery resulted in the alleviation of clinical symptoms and reduction of tumor burden while potentially achieving long-term survival. For hepatic metastases of SPNs, a preoperative liver tissue biopsy is beneficial for a definitive diagnosis. Surgery demonstrates excellent therapeutic efficacy and is considered the preferred curative treatment approach. This paper presents clinical experiences with SPN-related hepatic metastases at the Affiliated Hospital of Jilin University, which can be used to guide patient counseling in clinical practice.

Pseudopapillary solid tumor of the pancreas: case report and literature review

Solid pseudopapillary tumor of the pancreas (NSSP) is a rare tumor entity, of unknown cause and good prognosis. It mainly affects women between 25 and 35 years of age. Occasionally, it occurs in the pediatric age group and is characterized by the presence of abdominal pain and mass. Treatment is complete surgical resection. The following clinical case of a 10-year-old girl is shared in order to report the diagnostic and therapeutic experience of this disease. The patient debuted with pain and tumor mass at abdominal level, being initially diagnosed as Wilms tumor; however, due to the lack of response to chemotherapy, it was decided to perform an exploratory laparotomy, finding a mass confined to the body and tail of the pancreas. Pathological anatomy concluded that it was a NSSP. There is little documented evidence on this disease, especially in the pediatric population, so the case is important. It is a disease with a good prognosis and low mortality after surgical treatment.

Diagnosis and treatment of solid pseudopapillary tumor of the pancreas: A single center's experience.

The present study reviews the records of patients with solid pseudopapillary pancreas neoplasm (SPT). A total of 13 patients diagnosed with SPT were included in the study. The criteria for SPT in the pathology specimens were the presence of cells with an oval round orthochromatic nucleus, with a thin chromatin structure and no nucleolus distinction, lined around a fibrovascular papilla in cystic areas. The study included 11 female and two male patients, with a mean age of 33.07 (range: 16-73) years. All operated patients underwent open surgery, with five undergoing a subtotal pancreatectomy and splenectomy; one a distal pancreatectomy and splenectomy; four a spleen-preserving distal pancreatectomy; and one a pancreaticoduodenectomy. None of the operated patients developed recurrence during the long-term follow-up. The mean follow-up time of operable patients was 69.18 (range: 22-97) months, and none had metastasis at follow-up. The mean follow-up time for the malignant SPT patients was 2.75 (1.5-4) months. SPTs are rare pancreatic tumors encountered more frequently today due to advances in imaging methods and have a low potential of recurrence and a good prognosis.

Identifying factors that are associated with survival in patients with solid pseudopapillary tumors of the pancreas: a national cancer database analysis

Identifying factors that are associated with survival in patients with solid pseudopapillary tumors of the pancreas: a national cancer database analysis

Solid pseudopapillary tumor of the pancreas: is enucleation safe?

Solid pseudopapillary tumor of the pancreas: is enucleation safe?

Solid pseudopapillary neoplasms of the pancreas: single-center case series

Solid pseudopapillary neoplasms of the pancreas: single-center case series

Minimally invasive versus open resection for solid pseudopapillary tumors of the pancreas: a study of 740 cases

Minimally invasive versus open resection for solid pseudopapillary tumors of the pancreas: a study of 740 cases

Robotic pancreatic surgery in pediatric patients: is it safe and feasible – a case of robotic distal pancreatectomy in a fourteen years old patient with solid pseudopapillary neoplasm

Robotic pancreatic surgery in pediatric patients: is it safe and feasible – a case of robotic distal pancreatectomy in a fourteen years old patient with solid pseudopapillary neoplasm

Outcomes of patients diagnosed with Solid Pseudopapillary Tumors (SPT) of the pancreas over the last 20 years in a single center

Outcomes of patients diagnosed with Solid Pseudopapillary Tumors (SPT) of the pancreas over the last 20 years in a single center

Central Pancreatectomy - A Novel Surgical Technique Single Institution Experience.

Children evaluated for abdominal pain are increasingly recognized to have pancreatic lesions by imaging modalities. Malignant lesions of the pancreas have also been diagnosed at regular intervals, the most common being solid cystic pseudopapillary neoplasm (SPT) - Borderline (uncertain malignant potential). Surgical resection of this tumor should provide adequate tumor free margins and also should preserve pancreatic tissue. Radical resection of the pancreas will lead to pancreatic insufficiency. Herein, we describe the technique of central pancreatectomy wherein tumor excision gives adequate clearance but preserves the pancreatic tissue, thereby reducing significant morbidity. Three children ages ranging between 11 to 12 years diagnosed to have SPT were included in the study. All children underwent successful central pancreatectomy and had an uneventful post operative recovery. Central pancreatectomy offers a good volume of remanant pancreas preserving near normal pancreatic function making it an ideal procedure for select cases.

Robotic en-bloc resection of a locally advanced solid pseudopapillary neoplasm

Robotic en-bloc resection of a locally advanced solid pseudopapillary neoplasm

Radical antegrade modular pancreato-splenectomy for a large solid pseudopapillary neoplasm of pancreas in an elderly female: an unusual presentation

Radical antegrade modular pancreato-splenectomy for a large solid pseudopapillary neoplasm of pancreas in an elderly female: an unusual presentation

Minimally invasive versus open resection for solid pseudopapillary tumors: a study of 740 cases

Minimally invasive versus open resection for solid pseudopapillary tumors: a study of 740 cases

Solid pseudopapillary tumor of pancreas: experience from a tertiary center in Kerala

Solid pseudopapillary tumor of pancreas: experience from a tertiary center in Kerala

Surgery for Solid Pseudopapillary Neoplasm: Observational Study at a Nepalese Tertiary Center

Introduction: Solid pseudopapillary neoplasms (SPN) are rare, relatively indolent tumors with potential malignant behavior. This study aimed to analyze the clinicopathological details, surgical management, and short- and long-term outcomes of operated cases of SPN. Methods: This was an observational descriptive study of diagnosed SPNs confirmed histopathologically after surgical resections at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from 2006 November to 2019 January. Patient’s clinical details, surgical procedures, perioperative outcomes, and follow-up were recorded. Long-term follow-up was evaluated for a minimum of three years post-surgery. Results: Over 13 years, a total of 15 cases with a median age of 22 years (11-52) were encountered and had female predominance (14, 93.3%). Five cases were diagnosed incidentally, while pain abdomen (5, 33.3%) was the most common presentation followed by lump (4, 26.7%). There were four tumors in the head of the pancreas, two in the uncinate process, two in the neck, four in the body, and three in the tail of the pancreas. Four cases underwent pancreaticoduodenctomy, three cases underwent enucleation, and four cases underwent central pancreatectomy. Similarly, one patient underwent spleen preserving distal pancreatectomy and three patients underwent distal pancretosplenectomy. Postoperatively, 20% developed major complications with Clavien-Dindo (grade III &amp; above) out of which one patient had mortality. Over the median follow-up of 72 months, no recurrences were noted. Conclusion: Solid pseudopapillary neoplasms were relatively rare. Complete surgical resection was the most commonly used surgical management, post-operative complications were minimal and survival rate was excellent.