Solid pseudopapillary tumors of the pancreas: diagnosis and treatment

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Author:
WU Jun-li(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
WEI Ji-shu(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
MIAO Yi(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
QIAN Zhu-yin(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
DAI Cun-cai(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
XU Ze-kuan(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
JIANG Kui-rong(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
LI Qiang(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
GAO Wen-tao(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
GUO Feng(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
CHEN Jian-min(Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029,China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 9, Issue 04, 2009
DOI:
10.3760/cma.j.issn.1674-1935.2009.04.01O
Key Word:
Pancreatic neoplasm; Diagnosis; Surgical treatment; Solid pseudopapillary tumor

Abstract: Objective To summarize the experience in the diagnosis and treatment of solid pseudopapillary tumors of the pancreas. Methods Ten consecutive patients who underwent surgery with pathologically confirmed solid pseudopapillary tumors of the pancreas between October 2005 and December 2008 were retrospectively reviewed. Results All of the 10 patients were female and the median age at diagnosis was 24 years (range, 11 -39 years). Abdominal discomfort or pain were the most common presenting symptoms. 4 patients had palpable abdominal mass at physical examination. The tumors appeared on ultrasonography and/or CT, MRI as solid or cystic masses. The preoperative serum biochemical parameters and tumor markers level were within the normal range. All the patients underwent surgical treatment. The tumors were located in the head/neck (n = 6) or the distal part (n = 4) of the pancreas. The surgical procedures included enucleation (n=3) , distal pancreatectomy (n=3 , two with preservation of the spleen, one combined with splenectomy, distal gastrectomy and partial colectomy) , segmental pancreatectomy with pancreaticojejunostomy (n=3) and pancreaticoduodenectomy (n = 1). Pancreatic fistula (n = 2) was observed postoperatively and resolved with conservative treatment. The median resected tumor size was 5. 9 cm. All patients were alive and remained recurrence and metastasis free after a median followk-up of 19. 2 months (range, 8~42 months). Conclusions Solid pseudopapillary tumor of the pancreas was rare neoplasm occurred predominantly in young women with low malignant potential. Aggressive resection should be attempted and could result in excellent prognosis.

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