Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas

Hanada, Keiji; Kurihara, Keisuke; Itoi, Takao; Katanuma, Akio; Sasaki, Tamito; Hara, Kazuo; Nakamura, Masafumi; Kimura, Wataru; Suzuki, Yutaka; Sugiyama, Masanori; Ohike, Nobuyuki; Fukushima, Noriyoshi; Shimizu, Michio; Ishigami, Kousei; Gabata, Toshifumi; Okazaki, Kazuichi

doi:10.1097/mpa.0000000000001114

Cited by 51 publications

(46 citation statements)

References 18 publications

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“…The largest single-institution case series from Europe (n = 52) reported that the female-to-male ratio was 5.5:1 [8], and the ratio was 6.1:1 in the largest single-institution case series from the US (n = 78) [4]. A multicenter analysis in Korea reported that the female-to-male ratio was 9.3:1 [5], while a nationwide multicenter study in Japan and the largest single-institution case series from China (n = 243) found that the ratio was 3:1 [7,24]. The female-to-male ratio was 4:1 in our study, indicating a difference in incidence between different countries and races and that the number of male patients is increasing.…”

Section: Discussionmentioning

confidence: 95%

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: Discussionmentioning

confidence: 95%

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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“…8 higher likelihood of degeneration such as cysts or calcification with increasing tumor diameter, whereas small tumors of 2 cm or smaller are often observed as solid tumors without these types of degeneration. 2 Even among the 53 cases in our study, a number had tumors of 2 cm or smaller without cysts or calcification; thus, the differential diagnosis between PDC or PNEN is difficult with imaging examinations alone.…”

Section: Discussionmentioning

confidence: 57%

“…Under World Health Organization classification, SPN has low malignant potential, but metastases occur occasionally. [2][3][4][5] In a previous National Survey on SPN, we investigated the clinical pathology characteristics of 288 cases. The clinical characteristics included 5 cases (1.7%) with distant metastases, and postoperative recurrence was observed in 6 cases (2.1%); however, the 5-year survival rate was good at 98.8%, and complete resection is reported to be important for treatment.…”

Section: Discussionmentioning

confidence: 99%

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Investigation of Fluorodeoxyglucose Positron Emission Tomography for the Diagnosis of Solid Pseudopapillary Neoplasm of the Pancreas

et al. 2019

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Objectives: This study aimed to investigate the utility of fluorodeoxyglucose (FDG) positron emission tomography for solid pseudopapillary neoplasm (SPN) diagnosis. Methods: The subjects included 53 cases of SPN. We compared the maximal standardized uptake volume (SUVmax) with those of 25 cases of pancreatic duct cancer and 18 cases of pancreatic neuroendocrine neoplasm. In addition, immunopathological testing for SPN with regard to FDG uptake was undertaken. Results: An increase in SUVmax was observed in all tumors with increased tumor diameter. Among tumors of 20 mm or smaller, the SUVmax of SPN was significantly higher than those of pancreatic duct cancer and pancreatic neuroendocrine neoplasm. The results of a pathological study of FDG uptake in SPN revealed increased glucose transporter protein type 1 expression with tumor enlargement. Furthermore, increased hypoxiainducible factor-1 and vascular endothelial growth factor expression under hypoxic conditions were observed in the areas of necrosis. Conclusions: In cases in which high FDG uptake is observed in small pancreatic tumors, FDG positron emission tomography is potentially useful for SPN differentiation. The factors involved in FDG uptake in SPN include cell density and glucose transporter protein expression, as well as hypoxia-inducible factor and vascular endothelia growth factor expression in the hypoxic environment of necrotic areas.

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“…In large-scale studies 2.1-22.8% of the treated SPNs proved to be malignant based on local recurrences or metastases [5,[25][26][27][28]. The 5-year survival is excellent, reaching 93.6-98.8% [26,29,30], and even the 10-year disease-specific survival rate is 96% [31]. The local recurrence rate is low (less than 10% after 5 years of resection) [31].…”

Section: Biological Behaviormentioning

confidence: 99%

Solid-pseudopapillary Neoplasms of the Pancreas is still an Enigma: a Clinicopathological Review

Zalatnai

Kis-Orha

2019

Pathol. Oncol. Res.

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The solid-pseudopapillary neoplasm of the pancreas is a rare but enigmatic entity occurring mainly in young women. Since the first description by V. Frantz in 1959 the terminology of this tumor has continuously changed but it has remained simply descriptive, because the exact histogenesis is still obscure. Although in majority of cases the survival is excellent, nevertheless, the expected prognosis is not exactly predictable. In this review the authors aim to summarize its clinico-pathological features, the expected biological behavior, the molecular alterations, the immune phenotype and discuss the putative histogenesis. From diagnostic point of view, the salient histological characteristic findings are analyzed that would help to differentiate it from other, look-alike pancreatic tumors, and suggestions are made about the desirable content of the histological report.

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Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas

Cited by 51 publications

References 18 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

Investigation of Fluorodeoxyglucose Positron Emission Tomography for the Diagnosis of Solid Pseudopapillary Neoplasm of the Pancreas

Solid-pseudopapillary Neoplasms of the Pancreas is still an Enigma: a Clinicopathological Review

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