Percutaneous Cytologic Diagnosis of Solid Pseudopapillary Tumors of Pancreas in Children

Abstract

Solid pseudopapillary tumors of the pancreas, formerly known as Frantz tumors, are rare exocrine tumors that electively affect young women in their second and third decades of life, and are rarely observed in children. Histologic confirmation is nevertheless desirable before proceeding with treatment of pancreatic lesions, as appropriate treatment can range from conservative to ablative surgery. Here, we report 3 cases of solid pseudopapillary tumors of the pancreas and we postulate that percutaneous cytologic sample analysis (instead of biopsy) may be sufficient to reach an accurate diagnosis and eliminate differential diagnosis.

Recurrence of Solid Pseudopapillary Neoplasms of the Pancreas: Results of a Nationwide Study of Risk Factors and Treatment Modalities

“…Abdominal blunt injury has been incriminated in tumor spread at initial diagnosis, and laparoscopic biopsy was held responsible for peritoneal recurrence in the first report of laparoscopic management of SPPN . Later studies supported the safety of both percutaneous needle aspiration and laparoscopy for the diagnosis and treatment of SPPN . In our series, we found no significant influence of laparoscopy or tumor rupture, either pre‐ or perioperatively, on the risk of relapse.…”

“…In total, we collected data on 51 patients, of whom 16 have already been described in case reports or short series . The data collected included demographic features (age at diagnosis, presenting signs and symptoms such as abdominal pain/trauma/mass, pancreatitis, and other incidental findings), biological and radiological characteristics (tumor size and location, homogeneity or heterogeneity, dilatation of the main pancreatic duct or common bile duct, invasion of adjacent organs, venous thrombosis), preoperative biopsy (percutaneous fine‐needle aspiration or surgical biopsy), treatment modalities, postoperative morbidity, pathologic analysis of the specimen (presence of a capsule, resection margins, neural or vascular invasion, necrosis or lymphadenopathy, signs of tumor rupture), and survival.…”

Frantz tumor – a rare cause of abdominal pain in children – case report

“…Unfortunately, there are no conclusive radiological features that allow one to distinguish SPN from other pancreatic tumors. Biopsy and histopathology are necessary to make a definitive diagnosis [13,16,21].…”

Solide pseudopapilläre Pankreasneoplasie bei Kindern und Jugendlichen

“…Aufgrund der bildmorphologisch schwer abzugrenzenden Lokalisation der Tumore, werden in der Literatur die endosonographische transgastrale Biopsie sowie auch laparoskopische und in speziellen Fällen offen-chirurgische Probengewinnungen diskutiert [8]. Auch über die sonographisch-gesteuerte, perkutane Feinnadelaspiration wurde in Einzelfällen berichtet [29]. Für die Diagnostik seltener Pankreastumore bei Kindern bedarf es einer speziellen pathologischen Expertise.…”

“…Gleiches gilt für Tumorenukleationen und En-bloc-Exzisionen bei SPN, die in der Literatur berichtet werden. Aufgrund des malignen Potenzials muss generell eine radikale Resektion vorgezogen werden 26 30 .…”