Objectives The aim of the study was to determine if there had been any change in the number of solid-pseudopapillary neoplasms (SPN) cases detected, their evaluation or the management over time. Methods A systematic review of SPN was performed of all articles published in English in PubMed and SCOPUS. Results 2,744 patients with SPN identified in 484 studies published between 1961-2012; 87.8% cases were reported between 2000-2012. 2,408 (87.8%) females and the mean age was 28.5 years (S.D. ± 13.7). The most common symptom was abdominal pain in 63.6% and incidentally detected in 38.1%. There were 2,285 patients who underwent pancreatic resection. The mean tumor size was 8.6 cm (S.D ± 4.3). Follow-up was reported for 1,952 (90.5%) patients, with mean follow-up of 36.1 months (S.D. ± 32.8). Disease-free survival was documented in 1,866 (95.6%) patients with recurrence in 86 (4.4%); median time to recurrence was 50.5 months. Conclusions The number of SPNs reported in the literature has seen a 7-fold increase in the number of cases reported since 2000 compared to before. SPNs continue to be primarily found in young women and present with non-specific symptoms. Surgery remains the mainstay of treatment with an excellent long term prognosis.

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The gut microbiome is increasingly recognized for its role in human health and disease. Initial evidence indicates that gut microbial dysbiosis is associated with several pancreatic diseases. Although it is not known if these associations are causative, gut dysbiosis is hypothesized to mediate chronic pro-inflammatory changes in the pancreas. Further mechanistic and epidemiological studies of the microbiome are needed. Ultimately, targeted modulation of the microbiota could have therapeutic value.

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