Abstract
Background/Purpose
The best surgical treatment for solid pseudopapillary tumor of the pancreas is a matter of debate.
Methods
Fourteen patients with solid pseudopapillary tumor of the pancreas who underwent surgical resection, including enucleation, between June 1996 and January 2007 were retrospectively analyzed to evaluate the effect of the treatment.
Results
The mean age of the patients was 39 years (range, 15 to 59 years). The mean size of the tumor was 4.4 cm (range, 2.0 to 12 cm). Ten tumors (71%) had a well-defined capsule, and 6 tumors (43%) extended beyond the pancreas. Eight of the 14 tumors (57%) had a cystic component, and calcification was observed in 6 tumors (43%). The frequency of microscopic venous invasion, lymphatic invasion, and nerve invasion was 29% (4 of 14), 0%, and 21% (3 of 14), respectively. No lymph node involvement or liver metastasis was observed. Six patients underwent positron emission tomography with 2-deoxy-2-[18F] fluoro-D-glucose (FDG), and stronger FDG accumulation compared with the surrounding pancreatic parenchyma was observed in 5 of the 6 patients. The median standardized uptake value (SUV) was 6.3 (range, 0.9 to 42.8). Distal pancreatectomy (n = 5), subtotal stomach-preserving pancreatoduodenectomy (n = 3), local resection (n = 3), enucleation (n = 2), and duodenum-preserving pancreatic head resection (n = 1) were performed. Overall morbidity and mortality rates were 43% and 0%, respectively. All patients were still alive without recurrent disease after a median follow-up of 46 months.
Conclusions
Patients with solid pseudopapillary tumor of the pancreas had a favorable outcome after surgical treatment, including enucleation.
Similar content being viewed by others
References
Martin RC, Klimstra DS, Brennan MF, Conlon KC. Solid-pseudopapillary tumor of the pancreas: a surgical enigma? Ann Surg Oncol 2002;9:35–40.
Zinner MJ, Shurbaji MS, Cameron JL. Solid and papillary epithelial neoplasms of the pancreas. Surgery 1990;108:475–480.
Uchimi K, Fujita N, Noda Y, Kobayashi G, Kimura K, Matsunaga A, et al. Solid cystic tumor of the pancreas: report of six cases and a review of the Japanese literature. J Gastroenterol 2002;37:972–980.
Yoon DY, Hines OJ, Bilchik AJ, Lewin K, Cortina G, Reber HA. Solid and papillary epithelial neoplasms of the pancreas: aggressive resection for cure. Am Surg 2001;67:1195–1199.
Ashton J, Sutherland F, Nixon J, Nayak V. A case of solidpseudopapillary tumor of the pancreas: preoperative cyst fluid analysis and treatment by enucleation. Hepatogastroenterology 2003;50:2239–2241.
Bektas H, Werner U, Kaaden S, Philippou S, Kloppel G, Klempnauer J. Solid-pseudopapillary tumor of the pancreas—a rare and frequently misdiagnosed neoplasm. Langenbecks Arch Surg 1999;384:39–43.
Panieri E, Krige JE, Bornman PC, Graham SM, Terblanche J, Cruse JP. Operative management of papillary cystic neoplasms of the pancreas. J Am Coll Surg 1998;186:319–324.
Koyama K, Okamura T, Kawabe J, Nakata B, Chung KH, Ochi H, et al. Diagnostic usefulness of FDG PET for pancreatic mass lesions. Ann Nucl Med 2001;15:217–224.
Higashi T, Saga T, Nakamoto Y, Ishimori T, Fujimoto K, Doi R, et al. Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET)—usefulness and limitations in “clinical reality”. Ann Nucl Med 2003;17:261–279.
Lucignani G, Paganelli G, Bombardieri E. The use of standardized uptake values for assessing FDG uptake with PET in oncology: a clinical perspective. Nucl Med Commun 2004;25:651–656.
Potrc S, Kavalar R, Horvat M, Gadzijev EM. Urgent Whipple resection for solid pseudopapillary tumor of the pancreas. J Hepatobiliary Pancreat Surg 2003;10:386–389.
Gedaly R, Toledano A, Millan G, Essenfeld H, Zambrano VJ. Treatment of liver metastases from a solid pseudopapillary tumor of the pancreas. J Hepatobiliary Pancreat Surg 2006;13:587–590.
Author information
Authors and Affiliations
About this article
Cite this article
Nakagohri, T., Kinoshita, T., Konishi, M. et al. Surgical outcome of solid pseudopapillary tumor of the pancreas. J Hepatobiliary Pancreat Surg 15, 318–321 (2008). https://doi.org/10.1007/s00534-007-1264-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00534-007-1264-z