Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas at a Single Institution

Abstract

Aims: The aim of this study was to determine the clinicopathological features and surgical management of solid pseudopapillary neoplasms (SPNs) of the pancreas at a single institution. Methods: We investigated 34 patients (5 males and 29 females) who underwent surgery for pathologically confirmed SPNs between 1994 and 2012. Results: Clinical symptoms were absent in 58.8% of the patients. The median tumor diameter was 42.7 mm. All tumors were successfully removed by R0 resection. Pathologically, 5.9% had duodenum invasion and 2.9% had pancreatic serosal invasion, but there was no lymph node metastasis. Radiological findings showed calcification in 39.4% of the patients, capsule formation in 51.5%, cystic components in 69.7%, solid components in 93.9% and internal bleeding in 36.4%. Immunohistochemically, neuron-specific enolase was positive in 100% of the patients, nuclear accumulation of β-catenin in 100% and CD10 in 78.8%. There were no recurrences reported at the median follow-up (67 months). Regarding gender differences, the cystic component in radiological imaging was the only significant finding among the features studied (p = 0.01). Conclusions: R0 resection with appropriate procedures appears to be sufficient for patients with SPNs, even for locally invasive tumors. There were no significant differences between genders except for the cystic component on radiological imaging.

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

“…32 The typical immunohistochemistry of SPNs includes positive staining for Vim, AAT, α-1-antichymotrypsin (AACT), and NSE, 33,34 but the unique immunohistochemical features with expression of PR and CD10 were not consistent. 8,35 According to recently published data, a particular dot-like intracytoplasmic expression of CD99 appears to be highly unique for SPN, 36,37 and this distinctive staining pattern was present in 86.9 % of our cases. Thus, CD99 accompanied by other useful markers would help establish the diagnosis of SPNs.…”

<p>Diagnosis and Surgical Treatment and Pathological Findings of Solid Pseudopapillary Tumor of the Pancreas: A Single-Institution Experience</p>

“…No extensive lymphatic dissection was required because we only found one patient with lymph node metastasis in our study (the patient was suspected to pancreatic cancer so the lymph nodes (NO. 10,11,18) around the body and tail of the pancreas were dissected)this concurs with the previous findings of Suzuki et al 22 The role of neo-adjuvant or adjuvant chemotherapy, and radiotherapy, in the treatment of SPT is limited, 23,24 but Brunetti et al find an interesting result that a patient diagnosed to SPTP with malignant transformation treated with adjuvant chemotherapy achieved a longduration. 25 In the present study, we found that pancreatic fistulas were the predominant complication (n=21 patients); grade A fistulas were found in 19 patients, while grade B fistulas were found in two patients; we did not identify any grade C fistulas.…”

Solid Pseudopapillary Neoplasm of the Pancreas: Experience of a Tertiary Hospital

“…Most patients mention unspecific symptoms, while the rest are asymptomatic and accidentally diagnosed (15,16). Abdominal pain or painless palpable abdominal mass is the commonest presentation, as occurred in our series.…”