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Mylonas KS, Doulamis IP, Tsilimigras DI, Nasioudis D, Schizas D, Masiakos PT, Kelleher CM. Solid pseudopapillary and malignant pancreatic tumors in childhood: A systematic review and evidence quality assessment. Pediatr Blood Cancer 2018; 65:e27114. [PMID: 29697193 DOI: 10.1002/pbc.27114] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/22/2018] [Accepted: 03/18/2018] [Indexed: 12/15/2022]
Abstract
A systematic review of 32 studies reporting on 489 children with pancreatic tumors was performed. The most prevalent histologic subtype was solid pseudopapillary tumor (SPT) (61.3%). Pancreaticoduodenectomy was the most commonly performed operation (48%). Neoadjuvant chemo/radiotherapy was utilized in 3.9, 36.2, 25, and 27.8% of patients with SPTs, pancreatoblastomas (PBLs), neuroendocrine tumors, and exocrine carcinomas, respectively. Adjuvant chemotherapy (75.6%) and radiation (34%) were most commonly utilized in PBLs. All-cause mortality was highest in exocrine carcinomas (50%). Overall, 98.8% of patients with SPTs survived. PBL exhibited the highest recurrence rate (14.7%) within a mean of 23.5 months.
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Affiliation(s)
- Konstantinos S Mylonas
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Pediatrics Working Group, Society of Junior Doctors, Athens, Greece
| | - Ilias P Doulamis
- Surgery Working Group, Society of Junior Doctors, Athens, Greece
| | - Diamantis I Tsilimigras
- Surgery Working Group, Society of Junior Doctors, Athens, Greece.,First Department of Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Nasioudis
- Surgery Working Group, Society of Junior Doctors, Athens, Greece.,Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Dimitrios Schizas
- Surgery Working Group, Society of Junior Doctors, Athens, Greece.,First Department of Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter T Masiakos
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Cassandra M Kelleher
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts
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2
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Chhadi TS, Deshpande AH, Chhadi SA, Kumbhalkar DT, Raut WK. A Solid Pseudopapillary Tumour of the Head of Pancreas: A Rare Case Report Diagnosed by Fine Needle Aspiration Cytology. J Clin Diagn Res 2016; 10:ED06-8. [PMID: 27504299 DOI: 10.7860/jcdr/2016/19456.7929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/02/2016] [Indexed: 02/06/2023]
Abstract
Solid Pseudopapillary Tumour (SPPT) is a distinctive tumour of low malignant potential with a striking and unexplained predilection for adolescent girls and young women. Hence it is important to distinguish this rare tumour from other pancreatic tumours with similar cytomorphologic features because an accurate preoperative diagnosis is highly desirable since these patients can have long survival with adequate surgery. We report a case of the rare SPPT of the pancreas in a young girl who presented with nonspecific pain in the abdomen. Radiological investigations revealed a solid cystic mass in relation to the uncinate process of pancreas and third part of duodenum. The mass was diagnosed to be a solid pseudopapillary neoplasm of pancreas on ultrasound guided FNAC. Surgical removal of the pancreatic tumour and detailed histologic study confirmed the cytologic diagnosis. We present this case because, to date, there are few case reports on the cytological diagnosis of this tumour, about 60 cases, diagnosed by Fine-Needle Aspiration Cytology (FNAC) are reported in the literature. With widespread availability of high-quality imaging systems and a better understanding of its pathology, the number of cases reported in the literature has been steadily increasing in recent years. In our case, the cytological diagnosis was done even before the detailed imaging findings were available, the cytological features of this tumour are highly characteristic and it is possible to differentiate it from other pancreatic tumours with relative ease.
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Affiliation(s)
- Tulsi Shyam Chhadi
- Assistant Professor, Department of Pathology, Government Medical College , Nagpur, India
| | | | - Shyam Atmaram Chhadi
- Associate Professor, Department of Radiology, Government Medical College , Nagpur, India
| | - Dinkar T Kumbhalkar
- Professor, Department of Pathology, Government Medical College , Nagpur, India
| | - Waman K Raut
- Head of the Department, Department of Pathology, Government Medical College , Nagpur, India
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3
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Hsiao TH, Cheng TY, Wang HP. Multifocal pancreatic tumors in a young woman. Gastroenterology 2015; 148:e5-6. [PMID: 25529810 DOI: 10.1053/j.gastro.2014.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 07/28/2014] [Indexed: 12/02/2022]
Affiliation(s)
- Tsung-Hsien Hsiao
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Tsu-Yao Cheng
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsiu-Po Wang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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4
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Petrosyan M, Franklin AL, Jackson HT, McGue S, Reyes CA, Kane TD. Solid Pancreatic Pseudopapillary Tumor Managed Laparoscopically in Adolescents: A Case Series and Review of the Literature. J Laparoendosc Adv Surg Tech A 2014; 24:440-4. [DOI: 10.1089/lap.2013.0511] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Mikael Petrosyan
- Department of Pediatric Surgery, Children's National Health System, Washington, DC
| | - Ashanti L. Franklin
- Department of Pediatric Surgery, Children's National Health System, Washington, DC
| | - Hope T. Jackson
- Department of Pediatric Surgery, Children's National Health System, Washington, DC
| | - Shannon McGue
- Department of Pediatric Surgery, Children's National Health System, Washington, DC
| | - Christine A. Reyes
- Department of Pathology, Children's National Health System, Washington, DC
| | - Timothy D. Kane
- Department of Pediatric Surgery, Children's National Health System, Washington, DC
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5
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Cai DM, Li YZ, Ma BY, Ling WW, Jiang Y, Zhang LY, Zhong XF, Zhang JY, Song B. Diagnostic value of ultrasound in detection of solid pseudopapillary tumor of the pancreas. Shijie Huaren Xiaohua Zazhi 2013; 21:1803-1810. [DOI: 10.11569/wcjd.v21.i19.1803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the diagnostic value of ultrasound in the detection of solid pseudopapillary tumor of the pancreas (SPTs).
METHODS: The data of ultrasound and contrast-enhanced ultrasound for 30 patients with pathologically confirmed SPTs were retrospectively analyzed. The rates of detection of SPTs by the two methods were compared using the χ2 test or Fisher's exact test.
RESULTS: Of 30 patients, 1 was male and the others were female. Their mean age was 30.5 years, ranging from 13 to 58 years. Fourteen tumors were located in the head of the pancreas, 4 in the body of the pancreas and 12 in the tail of the pancreas. The size of tumors ranged from 1.5 cm × 1.1 cm × 1.8 cm to 21 cm × 11 cm × 15 cm. Of 26 cases examined by ultrasound, 17 were correctly diagnosed, 1 had missed diagnosis, and 8 were diagnosed with other tumors of the pancreas. Of 4 cases examined by contrast-enhanced ultrasonography, 3 were correctly diagnosed and 1 was diagnosed with other tumor of the pancreas. There was no significant difference in the diagnostic accuracy between the two methods (64% vs 75%, P = 0.593).
CONCLUSION: SPTs exhibit some special ultrasound features, which may be helpful to diagnose this type of tumor.
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Mat Zin AA, Shakir KAR, Aminuddin AR, Mahedzan MR, Irnawati WAR, Andee DZ, Hassan SA, Ezane MA, Hasnan MN. Solid-pseudopapillary carcinoma: a case study and literature review. BMJ Case Rep 2012; 2012:bcr-2012-006495. [PMID: 22927280 DOI: 10.1136/bcr-2012-006495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Solid-pseudopapillary tumour (SPT) is a rare exocrine tumour of the pancreas and is considered to have low malignant potential. Few morphological criteria are used to predict malignant behaviour such as equivocal perineural invasion, angioinvasion and invasion to surrounding tissue, and should be designated as solid-pseudopapillary carcinoma (SPC). We report a case of SPC. Clinical and radiological findings are typical for SPT with no metastatic disease. There is no tumour recurrence after 4 months postresection. Clinical history and radiological findings were retrieved from the patient's record sheet and Viarad system. H&E staining and few immunoproxidase staining were reviewed by several pathologists. The histological findings are typical for SPT, with additional perineural invasion. There is no angioinvasion or capsular invasion identified. This is our first experience in diagnosing and managing SPC. We look forward to seeing the patient's disease status during her next routine follow-up. We expect good disease-free survival and very low risk of tumour recurrence, in view of only one risk factor (perineural invasion) and uninvolved surgical margins by the tumour.
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Affiliation(s)
- Anani Aila Mat Zin
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
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7
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Speer AL, Barthel ER, Patel MM, Grikscheit TC. Solid pseudopapillary tumor of the pancreas: a single-institution 20-year series of pediatric patients. J Pediatr Surg 2012; 47:1217-22. [PMID: 22703796 DOI: 10.1016/j.jpedsurg.2012.03.026] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 03/06/2012] [Indexed: 12/25/2022]
Abstract
PURPOSE Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm. The objective of this study was to review our institution's experience and provide an update on current management in the pediatric population. METHODS Our pathology database identified all patients with SPT for a 20-year period (1991-2011). Demographics, clinical characteristics, operative details, pathology, and outcomes data were retrospectively reviewed. RESULTS Eleven patients with SPT were identified. Most were female and Hispanic. Median age at resection was 14 years (9-17 years). Most patients presented with abdominal pain. Diagnostic imaging was most commonly an ultrasound or computed tomography. All tumors were resected en bloc. Median greatest tumor diameter was 5 cm (3.5-12 cm). Median length of stay was 8 days (5-19 days). Complications included pancreatic leak, chyle leak, delayed gastric emptying, fat malabsorption, and incisional keloid. Recurrence developed after 2.5 years in 1 patient with positive surgical margins. There were no metastases or deaths. Median follow-up was 1.4 years (0.6-5.9 years). CONCLUSION This pediatric series of SPT from a single institution corroborates previous reports in the literature. In our experience, SPT behaves like a low-grade malignancy and has an excellent prognosis. Surgical resection is dictated by tumor location and remains the treatment of choice.
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Affiliation(s)
- Allison L Speer
- Children's Hospital Los Angeles, Department of Pediatric Surgery, Los Angeles, CA 90027, USA
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Mete Ö, Yeğen G, Güllüoğlu MG, Kapran Y, Klöppel G. An Unusual Clinical Presentation of Pancreatic Solid Pseudopapillary Tumor With Ovarian Metastases: A Diagnostic Dilemma. Int J Surg Pathol 2011; 19:342-5. [DOI: 10.1177/1066896910397610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nguyen NQ, Johns AL, Gill AJ, Ring N, Chang DK, Clarkson A, Merrett ND, Kench JG, Colvin EK, Scarlett CJ, Biankin AV. Clinical and immunohistochemical features of 34 solid pseudopapillary tumors of the pancreas. J Gastroenterol Hepatol 2011; 26:267-74. [PMID: 21261715 DOI: 10.1111/j.1440-1746.2010.06466.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIM Clinicopathological data regarding pancreatic solid pseudopapillary tumors (SPT) in a multiethnic country are limited. The aim of the present study was to characterize pancreatic SPT in Australia. METHODS Clinicopathological features, treatment, immunohistochemical findings and outcome data of 34 patients (79% Caucasian, 12% Asian, 6% South Pacific Islander and 3% African) with pancreatic SPT were reviewed. RESULTS The most presenting complaint was abdominal pain. Median diameter of tumors was 60 mm (range: 20-220); predominantly located in the pancreatic tail (tail : body : head = 23:3:8). All tumors were resected and patients underwent surgery, including a liver resection for metastasis, all patients were alive after a median follow up of 70 months (IQR: 48-178). Two patients underwent repeated surgery for local recurrences with liver metastases after 8 and 18 months, which were successfully managed by surgical resection. Completeness of excision, perineural spread, vascular space invasion, mitotic rate and cellular atypia did not predict recurrence. In all cases, there was aberrant nuclear staining of beta-catenin and a loss of membranous expression of E-cadherin with aberrant nuclear localization of the cytoplasmic domain. Most pancreatic SPT were also strongly positive for CD10 (96%), progesterone receptor (79%), cytokeratin (28%), synapthophysin (26%) and chromogranin (15%). CONCLUSIONS Pancreatic SPT occur in all races and are uniformly indolent. Given complete resection of a pancreatic SPT is usually curative and recurrences can be treated with re-operation, correct diagnosis is important.
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Affiliation(s)
- Nam Q Nguyen
- Department of Gastroenterology, Bankstown Hospital, New South Wales, Australia
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10
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Baek JH, Lee JM, Kim SH, Kim SJ, Kim SH, Lee JY, Han JK, Choi BI. Small (<or=3 cm) solid pseudopapillary tumors of the pancreas at multiphasic multidetector CT. Radiology 2010; 257:97-106. [PMID: 20663966 DOI: 10.1148/radiol.10092089] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To analyze the imaging features of small (≤3 cm) solid pseudopapillary tumors (SPTs) seen at multiphasic multidetector computed tomography (CT) in comparison with those of larger SPTs. MATERIALS AND METHODS This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. CT images of 42 histopathologically proven SPTs in the pancreas were retrospectively reviewed. Two radiologists in consensus analyzed the CT findings for the shape, location, diameter, ratio of solid-to-cystic components, border and margin, enhancement pattern, and enhancement grade of the tumors, as well as the presence of calcification, dilatation of the pancreatic duct, and parenchymal atrophy. Then, according to the feature analysis results, the reviewers classified all SPTs as typical or atypical; they also subdivided all SPTs into small (≤3 cm) and large SPTs (>3 cm) depending on the tumor size. Differences in the morphologic features between small SPTs and large typical and atypical SPTs were statistically evaluated by using the Fisher exact test; differences in attenuation between the pre- and postcontrast images and in the dynamic enhancement pattern according to nodule size (≤3 cm versus >3 cm) were evaluated by using the χ(2) test or Fisher exact test for categorical variables. RESULTS There were 20 typical SPTs and 22 atypical SPTs. Of the 22 atypical SPTs, 12 (54%) were 3 cm or smaller in diameter and 10 (45%) were larger than 3 cm in diameter. Small atypical SPTs usually appeared as solid tumors with a sharp margin and without accompanying pancreatic duct dilatation or parenchymal atrophy. They also showed weak enhancement during the pancreatic phase and a gradually increasing enhancement pattern. All typical SPTs were larger than 3 cm and appeared as well-defined cystic and solid masses with heterogeneous enhancement, while all large atypical SPTs appeared as calcified solid masses or large cystic masses. CONCLUSION The imaging features of small SPTs are different from those of large SPTs, and small SPTs frequently appear as purely solid tumors with a sharp margin and gradual enhancement.
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Affiliation(s)
- Jee Hyun Baek
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
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11
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Surgical outcome of solid pseudopapillary tumor of the pancreas. ACTA ACUST UNITED AC 2008; 15:318-21. [PMID: 18535771 DOI: 10.1007/s00534-007-1264-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 08/21/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND/PURPOSE The best surgical treatment for solid pseudopapillary tumor of the pancreas is a matter of debate. METHODS Fourteen patients with solid pseudopapillary tumor of the pancreas who underwent surgical resection, including enucleation, between June 1996 and January 2007 were retrospectively analyzed to evaluate the effect of the treatment. RESULTS The mean age of the patients was 39 years (range, 15 to 59 years). The mean size of the tumor was 4.4 cm (range, 2.0 to 12 cm). Ten tumors (71%) had a well-defined capsule, and 6 tumors (43%) extended beyond the pancreas. Eight of the 14 tumors (57%) had a cystic component, and calcification was observed in 6 tumors (43%). The frequency of microscopic venous invasion, lymphatic invasion, and nerve invasion was 29% (4 of 14), 0%, and 21% (3 of 14), respectively. No lymph node involvement or liver metastasis was observed. Six patients underwent positron emission tomography with 2-deoxy-2-[(18)F] fluoro-D-glucose (FDG), and stronger FDG accumulation compared with the surrounding pancreatic parenchyma was observed in 5 of the 6 patients. The median standardized uptake value (SUV) was 6.3 (range, 0.9 to 42.8). Distal pancreatectomy (n = 5), subtotal stomach-preserving pancreatoduodenectomy (n = 3), local resection (n = 3), enucleation (n = 2), and duodenum-preserving pancreatic head resection (n = 1) were performed. Overall morbidity and mortality rates were 43% and 0%, respectively. All patients were still alive without recurrent disease after a median follow-up of 46 months. CONCLUSIONS Patients with solid pseudopapillary tumor of the pancreas had a favorable outcome after surgical treatment, including enucleation.
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Ji Y, Lou WH, Jin DY, Kuang TT, Zeng MS, Tan YS, Zeng HY, Sujie A, Zhu XZ. A series of 64 cases of pancreatic cystic neoplasia from an institutional study of China. World J Gastroenterol 2006; 12:7380-7. [PMID: 17143961 PMCID: PMC4087503 DOI: 10.3748/wjg.v12.i45.7380] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To recognize cystic neoplasia of the pancreas and thus to identify a panel of curable diseases.
METHODS: Sixty-four cases of cystic neoplasia of the pancreas, including 28 cases of intraductal papillary mucinous neoplasia (IPMN), 12 cases of serous cystic neoplasia (SCN), 11 cases of mucinous cystic neoplasia (MCN), 11 cases of solid pseudo-papillary neoplasia (SPN), and 2 cases of solid tumor with cystic degeneration were examined immunohistochemically for their expression of MUC1, MUC2, MUC4, MUC5AC, and MUC6, as well as other related antigens.
RESULTS: Adenoma type of IPMN and borderline lesions exhibited high expressions of MUC2, and MUC5AC. In contrast, IPMN with invasive carcinoma component showed MUC1 immunoreactivity. SCN was mainly positive for MUC1 and MUC6, while negative for MUC2, MUC4 and MUC5AC. Noninvasive MCN, regardless of its cellular atypia degree, was positive for MUC5AC and negative for MUC1. MUC1 expression was only observed in patients with an invasive component. No mucin expression was found in SPN.
CONCLUSION: Mucin profile may, in conjunction with histologic study, provide important information on tumor types and patient treatment of cystic neoplasia of the pancreas.
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Affiliation(s)
- Yuan Ji
- Cancer Hospital, Fudan University, Lingling Road 399, Shanghai 200032, China.
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13
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Choi SH, Kim SM, Oh JT, Park JY, Seo JM, Lee SK. Solid pseudopapillary tumor of the pancreas: a multicenter study of 23 pediatric cases. J Pediatr Surg 2006; 41:1992-5. [PMID: 17161189 DOI: 10.1016/j.jpedsurg.2006.08.024] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND/PURPOSE Solid pseudopapillary tumor (SPT) is a very rare form of childhood pancreatic tumor. This study was intended to analyze the clinicopathologic characteristics of this tumor in childhood. METHODS We retrospectively reviewed the medical records of patients who were pathologically diagnosed with SPT between March 1991 and March 2005. RESULTS Twenty-three patients underwent an operation and were pathologically diagnosed with SPT. Five (22%) were male, with a male-to-female ratio of 1:3.6. The initial signs and symptoms were upper abdominal pain in 20 patients (87%), palpable abdominal mass in 8 (35%), and dyspepsia in 6 (26%). Four patients (17%) had a history of abdominal trauma. Tumors were located in the pancreatic head (30%), body (13%), tail (44%), and both body and tail (13%). Operative procedures performed were pylorus-preserving pancreaticoduodenectomy (n = 6, 26.1%), distal pancreatectomy (n = 7, 30.4%), distal pancreatectomy with splenectomy (n = 7, 30.4%). The median follow-up period was 62 months (range, 6-175 months). One patient showed multiple liver metastasis 3 months after the initial operation and required adjuvant chemotherapy. All other patients were alive at their most recent follow-up with no evidence of recurrence or distant metastasis. CONCLUSIONS Complete resection of an SPT is usually curative and patients can survive a long period after the operation.
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Affiliation(s)
- Seung Hoon Choi
- Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea.
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Tipton SG, Smyrk TC, Sarr MG, Thompson GB. Malignant potential of solid pseudopapillary neoplasm of the pancreas. Br J Surg 2006; 93:733-7. [PMID: 16609955 DOI: 10.1002/bjs.5334] [Citation(s) in RCA: 149] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Solid pseudopapillary neoplasms of the pancreas are rare malignant lesions of the pancreas that typically occur in young women. Large series from any one centre are notably absent in the literature. The aim of this study was to determine long-term outcomes of operative therapy. METHODS The records of all 14 patients diagnosed with pseudopapillary neoplasms of the pancreas over 17 years were reviewed. RESULTS Thirteen of the 14 patients were female and the mean age at diagnosis was 30 years. Solid pseudopapillary neoplasm was suspected in only half of these patients before operation. On computed tomography, ultrasonography and/or magnetic resonance imaging, three lesions were solid, three were largely cystic, and five had solid and cystic components. All 14 patients underwent surgical exploration and curative resections were possible in 13, including distal pancreatectomy in nine, pancreaticoduodenectomy in three and resection of a local intraperitoneal recurrence in one patient. After follow-up ranging from 3 months to 20 years, 12 patients were alive, including one who had undergone re-exploration and resection of local and subcutaneous recurrences 9 years previously. CONCLUSION Solid pseudopapillary neoplasm of the pancreas should be considered in the differential diagnosis of any solid or partly cystic pancreatic mass in women aged less than 35 years. An attempt at en bloc resection without formal lymphadenectomy should be undertaken, including resection of synchronous or metachronous distant metastases.
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Affiliation(s)
- S G Tipton
- Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55902, USA
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15
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Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms. Chin Med J (Engl) 2006. [DOI: 10.1097/00029330-200605010-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hernández-Puente A, Artigas V, Moral A, Magarzo J, Targarona E, Trías M. [Solid-pseudopapillary tumor of pancreas]. Cir Esp 2006; 77:233-5. [PMID: 16420924 DOI: 10.1016/s0009-739x(05)70844-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Solid-pseudopapillary tumor of pancreas is a very rare neoplasm of low malignant potential and unknown origin. It generally occurs in young women and the prognosis is usually good after complete surgical removal. Two cases of solid pseudopapillary tumor with distinct disease duration are reported.
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Affiliation(s)
- Angela Hernández-Puente
- Servicio de Cirugía General y del Aparato Digestivo, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain.
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17
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Hassan I, Celik I, Nies C, Zielke A, Gerdes B, Moll R, Ramaswamy A, Wagner HJ, Bartsch DK. Successful treatment of solid-pseudopapillary tumor of the pancreas with multiple liver metastases. Pancreatology 2005; 5:289-94. [PMID: 15855828 DOI: 10.1159/000085285] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The solid-pseudopapillary tumor (SPT) is a very rare pancreatic neoplasm that predominantly affects young females. About 450 cases have been described in the world literature and approximately 20% of the reported patients were children. The occurrence of SPT with distant metastases in children is extremely rare with only two previously reported cases. We now report a 16-year-old Asian girl with a large SPT and synchronous multiple liver metastases who was successfully treated in a 2-step strategy, including initial pylorus-preserving partial duodenopancreatectomy, right hemicolectomy, resection and allografting of the portal vein and secondary resection of 12 liver metastases. The patient is disease free after a follow-up of 18 months after resection of the primary tumor, suggesting that an aggressive surgical treatment might also be justified for metastasized SPT.
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Affiliation(s)
- I Hassan
- Department of Surgery, Institute of Theoretical Surgery, Philipps University of Marburg, Marburg, Germany
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Abstract
This article discusses serous cystadenomas, the most common of the nonmucinous cystic lesions of the pancreas. These microcystic lesions were previously known as "glycogen-rich" cystadenomas because of the presence of glycogen within the cyst epithelium. A small percentage of these lesions are macrocystic, and it may be difficult to differentiate them from mucinous lesions; however, endoscopic ultrasound guided fine needle aspiration can provide diagnostic material from the cyst fluid. The second most common nonmucinous cyst, the islet cell tumor, is also discussed. These rare cystic tumors may or may not be accompanied by excess hormone production. The prognosis for the rare cystic tumors is good if they are resected successfully.
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MESH Headings
- Adenoma, Islet Cell/diagnosis
- Adenoma, Islet Cell/epidemiology
- Adenoma, Islet Cell/surgery
- Biopsy, Needle/methods
- Biopsy, Needle/standards
- Carcinoma, Islet Cell/diagnosis
- Carcinoma, Islet Cell/epidemiology
- Carcinoma, Islet Cell/surgery
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/epidemiology
- Cystadenoma, Serous/surgery
- Diagnosis, Differential
- Endosonography/methods
- Endosonography/standards
- Humans
- Pancreatic Cyst/diagnosis
- Pancreatic Cyst/epidemiology
- Pancreatic Cyst/surgery
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/epidemiology
- Pancreatic Neoplasms/surgery
- Prognosis
- Ultrasonography, Interventional/methods
- Ultrasonography, Interventional/standards
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Affiliation(s)
- Michelle A Anderson
- Endoscopic Ultrasound Program, Division of Gastroeterology, Department of Internal Medicine, University of Michigan Medical Center, 3912 Taubman Center/0362, Ann Arbor, MI 48109-0632, USA
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19
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Patel VG, Fortson JK, Weaver WL, Hammami A. Solid-Pseudopapillary Tumor of the Pancreas Masquerading as a Pancreatic Pseudocyst. Am Surg 2002. [DOI: 10.1177/000313480206800716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Solid-pseudopapillary tumor of the pancreas is a very rare low-grade malignancy, predominantly occurring in adolescent girls and young women. Accurate diagnosis of this unusual tumor is important because the prognosis after surgical resection is excellent. We report a rare case of solid-pseudopapillary tumor of the pancreas in a 22-year-old woman that was misdiagnosed as a pancreatic pseudocyst on abdominal CT scan. This case emphasizes the importance of biopsying the pseudocyst wall at the time of drainage procedure if misdiagnosis is to be avoided. CT scan findings alone can not reliably rule out malignant cystic lesions of the pancreas.
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Affiliation(s)
| | - James K. Fortson
- Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia
| | - William L. Weaver
- Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia
| | - Amir Hammami
- Department of Pathology, South Fulton Medical Center, Atlanta, Georgia
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