Solid pseudopapillary neoplasm of the pancreas showing marked distal atrophy: A case report

Tsujie, Masanori; Wakasa, T.; Mizuno, Shigeto; Ishikawa, Hajime; Manabe, Hironobu; Koyama, Taichi; Kitani, Kotaro; Satoi, Shumpei; Inoue, Kazuo; Fukuda, Shuichi; Kawasaki, Toshihiko; Yukawa, Masao; Ohta, Yoshihiro; Inoue, Masatoshi

doi:10.1016/j.ijscr.2019.01.030

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…However, it was not recognized by the WHO as a low-grade epithelial malignant neoplasm until 2010 (1,2). It was reported to have an incidence of 1-2% of all pancreatic tumors with a favorable prognosis after surgical excision (3). SPNs are…”

Section: Introductionmentioning

confidence: 99%

Huge solid pseudopapillary tumor of the pancreas ‘Frantz tumor’: a case report

AlQattan

Alshaqaq

Abdrabalnabi

et al. 2020

J Gastrointest Oncol

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Solid pseudopapillary neoplasms (SPN) of the pancreas are rare neoplasms accounting for 1-2% of all pancreatic tumors and have a general female predominance. We report a case and intraoperative videos of SPN involving the whole pancreatic tail. A 19-year-old female patient initially presented to another healthcare facility complaining of abdominal pain, which was started 6 years ago. A contrast-enhanced Computed Tomography (CT) scan of the abdomen showed a large mass measuring 15.6 cm × 11.6 cm × 11 cm, arising from the pancreas with an enhancing cystic component. The patient underwent exploratory laparotomy, which revealed a huge mass occupying most of the abdominal cavity. Thus, we proceeded with a distal pancreatectomy and splenectomy. Intraoperatively, the frozen section showed that the mass had features of a solid pseudopapillary tumor of the pancreas with negative resection margins. The SPN diagnosis was confirmed by histopathology and immunohistochemistry. The pathophysiology behind the development of SPN and its cellular origin is still a matter of debate with multiple proposed hypotheses.SPNs are asymptomatic in almost 70% of all cases and usually discovered incidentally. The pre-operative diagnosis of SPNs remains a clinical challenge despite all the current advances in the diagnostic modalities. Surgical management with negative resection margins is the mainstay of treatment, even with metastasis and vascular invasion, surgical excision should be performed whenever feasible. The recurrence rate after surgical resection has been reported to be 3-9%. The prognosis of SPN limited to the pancreas is generally excellent with over 95% cure rate following complete surgical resection. SPN is a rare entity of a controversial origin but is considered as a low-grade malignancy. Surgical resection to achieve complete excision constitutes the mainstay of treatment, which mostly results in an excellent prognosis.

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Section: Introductionmentioning

confidence: 99%

Huge solid pseudopapillary tumor of the pancreas ‘Frantz tumor’: a case report

AlQattan

Alshaqaq

Abdrabalnabi

et al. 2020

J Gastrointest Oncol

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Presumed radiological diagnosis of solid pseudopapillary tumors: do we really know what we are watching?

Zhu

Wang

et al. 2023

Pancreatology

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Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study

Guang-bin

Yin²,

Chen³

et al. 2023

Front. Surg.

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BackgroundDespite the advancements in surgical techniques, postoperative pancreatic fistula (POPF) remains a potentially life-threatening complication of pancreaticoduodenectomy (PD). Pancreatic duct occlusion (PDO) without anastomosis has also been proposed to alleviate the clinical consequences of POPF in selected patients after PD.ObjectivesTo assess the safety and effectiveness of PDO with mechanical closure after PD in patients with an atrophic pancreatic body-tail and a small pancreatic duct.MethodsWe retrospectively identified two female and two male patients from April 2019 to October 2020 through preoperative computed tomography of the abdomen. Among them, three patients underwent PDO with mechanical closure after PD, and one underwent PDO after pylorus-preserving PD. In addition, patients' medical records and medium-and long-term follow-up data were analyzed.ResultsPostoperative histological examination revealed a solid pseudopapillary tumor in two patients, pancreatic ductal adenocarcinoma in one patient, and chronic pancreatitis with pancreatic duct stones in one patient. However, none of the patients developed biochemical or clinically relevant POPF, with no postpancreatectomy hemorrhage, biliary leakage, delayed gastric emptying, intra-abdominal abscess, or chyle leakage. Among the four patients, three developed new-onset diabetes mellitus, and one had impaired glucose tolerance. Furthermore, three patients received pancreatic enzyme supplementation at a dose of 90,000 Ph. Eur. units/d, and one was prescribed a higher dose of 120,000 Ph. Eur. units/d.ConclusionsPDO with mechanical closure is an alternative approach for patients with an atrophic pancreatic body-tail and a small pancreatic duct after PD. Therefore, further evidence should evaluate the potential benefits of selective PDO in these patients.

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Solid pseudopapillary neoplasm of the pancreas showing marked distal atrophy: A case report

Cited by 3 publications

References 18 publications

Huge solid pseudopapillary tumor of the pancreas ‘Frantz tumor’: a case report

Huge solid pseudopapillary tumor of the pancreas ‘Frantz tumor’: a case report

Presumed radiological diagnosis of solid pseudopapillary tumors: do we really know what we are watching?

Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study

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