Metastatic Solid-pseudopapillary Tumour of the Pancreas: Clinico-biological Correlates and Management

Solid pseudopapillary carcinoma of the pancreas: differentiation from benign solid pseudopapillary tumour using CT and MRI

“…1,16,18 Considering the favourable outcome, most current recommendations support aggressive management, targeting complete resection of both the primary tumour and the metastatic lesions whenever possible. 6,16,19 Pancreatic duct dilation was present in four of eight SPC patients in the present study. Furthermore, all four of these mass lesions, which were located in the pancreatic head, showed distal pancreatic ductal dilation.…”

“…2,4,10 In 1996, the WHO renamed this tumour SPT in the new classification of pancreatic neoplasms. 6,9 In contrast to conventional ductal adenocarcinomas, most SPTs, although often large in size, are usually well circumscribed, and complete surgical resection has been reported to provide more than a 95% cure rate. 1,8 According to the WHO classification of tumours of the exocrine pancreas, SPT is usually defined as a benign neoplasm composed of monomorphic cells forming solid and pseudopapillary structures, frequently showing haemorrhagicecystic changes, and variably expressing epithelial, mesenchymal, and endocrine markers.…”

“…Distant metastases develop in up to 15% of cases and they are most commonly present at diagnosis. 1,6 It is uncommon for metastases to develop later 6 ; however, they may occasionally develop with a latency of several years. 5,16 Common sites for metastatic disease are the liver, omentum, peritoneum, and lymph nodes.…”

Array comparative genomic hybridization analysis of solid pseudopapillary neoplasms of the pancreas

“…The morphologic features suggesting a benign or malignant phenotype are inadequate to predict tumor biology accurately. [1][2][3][4][5][6][7][8] The application of simple DNA-based ancillary techniques has yielded mixed results as applied to high-and low-risk solid pseudopapillary neoplasms. Flow cytometry studies have demonstrated a trend toward DNA aneuploidy in malignant solid pseudopapillary neoplasms, but diploidy has been observed in both malignant and 'benign' solid pseudopapillary neoplasms.…”

“…However, aggressive malignant solid pseudopapillary neoplasms have been reported. [1][2][3][4][5][6] Attempts to separate aggressive from non-aggressive solid pseudopapillary neoplasms based on histologic criteria (such as vascular invasion, necrosis, increased mitotic rate, high nuclear grade) and size has yielded contradictory results with reports of histologically bland solid pseudopapillary neoplasms that have metastasized and histologically malignant solid pseudopapillary neoplasms with indolent outcomes. 4,7,8 Using morphologic features to predict the biological behavior of solid pseudopapillary neoplasms has limitations and is a major obstacle in stratifying patients into low-and highrisk groups as has been observed for other lesions, such as pheochromocytomas and neuroendocrine tumors.…”