Aggressiveness of solid pseudopapillary neoplasm of the pancreas

Hao, Emmanuel Ii Uy; Hwang, Ho Kyoung; Yoon, Dong Sup; Lee, Woo Jung; Kang, Chang Moo

doi:10.1097/md.0000000000013147

Cited by 59 publications

(59 citation statements)

References 39 publications

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“…Patients with SPNs have a favorable prognosis, and the 5-year survival rate after surgical resection is more than 95% [5,11]. Long-term survival can be achieved after surgical resection even in patients with metastasis [12,13].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Lin

Lü

et al. 2020

Dig Surg

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Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare neoplasms, and the selection of surgical approaches is still under debate. The aim of this study was to analyze the clinicopathological characteristics and surgical outcomes of SPN patients and to compare the short-term and long-term outcomes between conventional operations and parenchyma-preserving operations. Methods: Patients who underwent pancreatic resection for SPNs between February 2010 and May 2019 in Fujian Medical University Union Hospital were identified. Clinicopathological details, perioperative data, and long-term follow-up results were retrospectively analyzed. Results: Sixty patients underwent surgical resection for SPNs during the study period: 48 females and 12 males. The mean age was 32.2 years. All patients underwent margin-negative surgical resection. The median follow-up period was 47 months (range: 3~118 months). One patient developed liver metastases 14 months after the operation and received local ablation therapy. All patients were alive during the follow-up. The incidence of postoperative pancreatic fistula was higher in the parenchyma-preserving surgery group than in the conventional surgery group (40.0 vs. 11.1%, p = 0.034). There was no significant difference in the tumor recurrence rate between the 2 groups. Eight (17.7%) and 6 patients (13.3%) in the conventional surgery group demonstrated endocrine and exocrine pancreatic insufficiency, respectively; furthermore, no patients in the parenchyma-preserving surgery group had endocrine or exocrine pancreatic insufficiency, but the incidences were not significantly different between the 2 groups. Conclusions: Margin-negative surgical resection of SPNs yields a very low rate of tumor recurrence and excellent long-term survival.

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Section: Introductionmentioning

confidence: 99%

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Lin

Lü

et al. 2020

Dig Surg

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“…In general, SPNs have good prognosis after surgery, with a recurrence rate of only 10-15% and a mortality rate of only 2% [8]. The most common metastatic target organ of an SPN is the liver, while other rare sites include the greater omentum, inguinal lymph nodes, and lungs [11,21].…”

Section: Discussionmentioning

confidence: 99%

“…The risk factors for the malignant behavior and poor prognosis of SPNs have not been fully elucidated to date, and the results have varied markedly among studies. Some reports have suggested that microscopic pathological characteristics, such as cell pleomorphism, prominent necrosis, perineural invasion of the surrounding tissue, and multiple mitotic figures, can predict the malignant potential of SPNs [8,22]. There are also reports that male sex, incomplete capsules, a young age (< 13.5 years), positive surgical margins during the initial tumor resections, and large tumor sizes may be associated with SPN recurrence [23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

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Solid-pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Chen

Huang

Yang

et al. 2021

Preprint

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Background:Asolid-pseudopapillary neoplasm (SPN) of the pancreas, a rare tumor, has low malignant potential. However, some patients develop metastasis and recurrence after resection, with aggressive biological behaviors of SPNs. This study aimedtoexplorethefeatures andriskfactors associated withtheaggressivebiological behaviorsofSPNs.Materials and Methods: We retrospectively analyzed the clinicopathological and long-term follow-up data of 63 patients with SPN diagnosed at the First Affiliated Hospital of Bengbu Medical College between January 2007 and February 2019.Results: The 63 patients presented with atypical clinical symptoms. The mean tumor size was 7.2 cm (range, 2.4–17 cm), and imaging features were solid and cystic or solid tumors with uneven density. Frequent and diffuse nuclear LEF1 expression (94.2%) was observed with LEF1 having a higher sensitivity and specificity. Overall survival significantly correlated with tumor size, Ki-67 index, and lymph node metastasis(P<0.05).Conclusions: SPN is a rare low-grade malignancy with a specific pseudopapillary structure. LEF1 is an effective biomarker of SPNs. Although SPNs generally display indolent biological behavior, a large tumor size, high proliferation index and lymph node metastasis may be risk factors for the aggressive behavior and poor prognosis of anSPN.

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“…Unresectable tumors and metastases occurring within 36 months are independent variables in predicting survival. Completely resected tumors, even those showing aggressive gross and morphologic features have excellent prognosis and patients can still survive for more than 10 years [52,53].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and immunohistochemical study of 29 cases of solid-pseudopapillary neoplasms of the pancreas in patients under 20 years of age along with detailed review of literature

et al. 2020

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Background Pancreatic Solid Pseudopapillary Neoplasms (SPNs) are rare low-grade malignant tumors with a marked preponderance for young females. Objective was to describe the morphology, differential diagnosis, and prognosis of SPNs in patients under 20 years of age and present a detailed review of literature. Methods A total of 29 cases in patients under 20 years of age reported as SPN during the period January 2014 to December 2019, were included in the study. These included 19 resection specimens, 4 incision biopsies and 6 cases received as blocks for second opinion. Hematoxylin and eosin (H&E) slides as well as immunohistochemistry (IHC) slides of all cases were retrieved and reviewed by the authors. TFE3 and Progesterone Receptor were performed retrospectively. Results Twenty-eight of the 29 patients were females. Ages of patients ranged from 12 to 19 years. Nineteen cases were resections. Tail was the commonest location. Mean tumor size was 9.5 cm. In 89.5% cases, tumor was confined to the pancreas. In 2 cases, distant metastasis was present. In 2 cases, extension beyond pancreas was seen. Solid and pseudopapillary areas were seen in all cases while other features were variable. Beta catenin and Cyclin D1 were positive in most cases while TFE3 was positive in 57% cases. Progesterone Receptor (PR) was positive in all 13 cases in which it was performed. Follow up was available in 14 patients. Follow up period ranged from 3 to 70 months. Twelve were alive and well without recurrence or metastasis while 2 were alive with recurrence and metastasis to liver and omentum respectively. Conclusions Although many studies on SPNs have been published, surgeons, oncologists and even pathologists in this part of the world are often not aware of these rare tumors leading to inaccuracies and delays in diagnosis. In addition, this paper focusses on the interesting observation that the majority of SPNs diagnosed in our department during study period occurred in patients under 20 years of age (29 versus 21 in patients over 20). However, clinico-epidemiological, morphologic and prognostic features were similar in both age groups. Possibility of SPNs should always be considered in case of pancreatic neoplasms occurring in patients under 20 years of age as well. We believe that this is a very interesting and helpful study for the clinicians as well as the pathologists.

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Aggressiveness of solid pseudopapillary neoplasm of the pancreas

Abstract: Supplemental Digital Content is available in the text

Cited by 59 publications

References 39 publications

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Solid-pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Clinicopathological and immunohistochemical study of 29 cases of solid-pseudopapillary neoplasms of the pancreas in patients under 20 years of age along with detailed review of literature

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