Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Abstract

Aim of this study was to review the institutional experience of solid-pseudopapillary tumors of the pancreas with particular attention to the problems of preoperative diagnosis and treatment. From 1997 to 2013, SPT was diagnosed in 18 patients among 451 pancreatic cystic neoplasms (3.7%). All patients underwent preoperative abdominal ultrasound, computed assisted tomography, and tumor markers (CEA and CA 19-9) determinations. In some instances, magnetic resonance, positron emission tomography, and endoscopic ultrasound with aspiration cytology were performed. There were two males and 16 females. Serum CA 19-9 was slightly elevated in one case. Preoperative diagnosis was neuroendocrine tumor (n = 2), mucinous tumor (n = 2), and SPT (n = 14). Two patients underwent previous operation before referral to our department: one explorative laparotomy and one enucleation of SPT resulting in surgical margins involvement. All patients underwent pancreatic resection associated with portal vein resection (n = 1) or liver metastases (n = 1). One patient died of metastatic disease, 77 months after operation, and 17 are alive and free with a median survival time of 81.5 months (range 36–228 months). Most of SPT can be diagnosed by CT or MRI, and the role of other diagnostic tools is very limited. We lack sufficient information regarding clinicopathologic features predicting prognosis. Caution is needed when performing limited resection, and long and careful follow-up is required for all patients after surgery.

The usefulness of lymphoid enhancer‐binding factor 1 and androgen receptor in diagnosing solid pseudopapillary neoplasm of the pancreas on cytopathology

“…Needless to say, no IHC profile is pathognomonic for the diagnosis of SPN, and much overlap in expression exists among the aforementioned tumors. The associated prognosis and necessary treatment modalities vary widely for each neoplasm, and therefore a combination of morphologic and IHC findings is of paramount importance …”

Incidence, prediction, and the long-term outcome of solid pseudopapillary tumor of the pancreas with malignant behaviors: a pooled-analysis

“…The detailed search strategy is depicted in Fig 1. A total of 98 studies were identi ed [4][5][6][7] . All studies were retrospective in nature.…”

“…The incidence of SPTM was reported in 22 articles [6,7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . Meta-analysis results suggested that the incidence of SPTM in solid pseudopapillary tumors of the pancreas was 22% [95%CI: 19-24%] (…”

“…Unfortunately, the biological behavior and clinical course of solid pseudopapillary tumor of the pancreas with malignant behaviors (SPTM) have not been well studied due to the low incidence. Although some studies have pay attention to the prediction and prognosis of SPTM, no consistent and reliable conclusions have been reached, and these investigations are almostly small samples and single center [6,7] . This research aimed to conduct a large sample analysis of the incidence and predictors with focusing on the survival and prognostic factors of SPTM through available articles in database.…”

Solid pseudopapillary neoplasm of the pancreas: a case report

“…CTNNB1 somatic mutation on exon 3 is the only known mutation in SPN to date. Like most tumours, when they are small, they are detected incidentally in imaging (USG, MRI, CT) [13][14][15][16][17][18]. Large tumours cause abdominal pain, abdominal discomfort, low-grade fever weight loss, and anaemia, and haemorrhage to the tumour may present a symptom of acute abdomen.…”