Our data demonstrated high penetrance of NF-PETs in 15- to 20-year-old MEN1 patients. The high percentage of the patients presenting consensus criteria for surgery for NF-PET alone or NF-PET/insulinoma suggests a potential benefit for the periodic surveillance of these tumors in this age group.
Background: Solid pseudopapillary pancreatic neoplasia is usually a large well-circumscribed
pancreatic mass, with cystic and solid areas more frequently found in young women.
It is a benign pancreatic neoplasia in most cases, therefore minimally invasive
surgery could be an interesting approach. Aim: Evaluate the results of minimally invasive surgery for this neoplasia. Methods: Patients with this tumor who underwent minimally invasive pancreatectomies
between 2009 and 2015 in a single institution, were analyzed regarding
demographic, clinical-pathological futures, post-operative morbidity and
disease-free survival. Results: All were women, and their median age was 39 (18-54) years. Two patients with
tumor in the head of the pancreas underwent laparoscopic pancreaticoduodenectomy,
and another one underwent laparoscopic enucleation. Two patients with tumor in the
neck underwent central pancreatectomy. Distal pancreatectomies were performed in
the other five, one with splenic preservation. None required blood transfusion or
conversion to open surgery. Two (20%) developed clinical relevant pancreatic
fistulas, requiring readmission. Median length of postoperative hospital stay was
five days (2-8). All resection margins were negative. Patients were followed for a
median of 38 months (14-71), and there was no recurrence. Conclusions: Minimally invasive surgery for solid pseudopapillary pancreatic neoplasia is
feasible for tumors in different locations in the pancreas. It was associated with
acceptable morbidity and respected the oncologic principles for treatment.
The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyps distributed along the small intestine. Enterotomy was performed to treat only the larger polyps, therefore limiting the intestinal resection to smaller segments. The postoperative follow-up was uneventful. CONCLUSION: We point out the importance of conservative treatment for patients with this syndrome, especially those who will undergo repeated surgical interventions because of clinical manifestation while they are still young.
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