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      Clinicopathologic features and surgical outcome of solid pseudopapillary tumor of the pancreas: analysis of 17 cases

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          Abstract

          Background

          We summarize our experience of the diagnosis, surgical treatment, and prognosis of solid pseudopapillary tumors (SPTs).

          Methods

          We carried out a retrospective study of clinical data from a series of 17 patients with SPT managed in two hospitals between October 2001 and November 2011.

          Results

          All of the 17 patients were female and the average age at diagnosis was 26.6 years (range 11 years to 55 years). The tumor was located in the body or tail in ten patients, the head in five patients, and the neck in two patients. The median tumor size was 5.5 cm (range 2 cm to 10 cm). All 17 patients had curative resections, including seven distal pancreatectomies, five local resections, four pancreaticoduodenectomies, and one central pancreatectomy. Two patients required concomitant splenic vein resection due to local tumor invasion. All patients were alive and disease-free at a median follow-up of 48.2 months (range 2 to 90 months). There were no significant associations between clinicopathologic factors and malignant potential of SPT. Ki-67 was detected in three patients with pancreatic parenchyma invasion.

          Conclusions

          The SPT is an infrequent tumor, typically affecting young women without notable symptoms. Surgical resection is justified even in the presence of local invasion or metastases, as patients demonstrate excellent long-term survival. Positive immunoreactivity for Ki-67 may predict the malignant potential of SPTs.

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          Most cited references15

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          Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature.

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            Solid-pseudopapillary tumor of the pancreas: a neoplasm with distinct and highly characteristic cytological features.

            The solid-pseudopapillary tumor of the pancreas (SPTP) is an unusual low-grade malignant epithelial tumor affecting predominantly adolescent girls and young women. Although approximately 500 cases of SPTP have been described in the last 40 yr, its pathogenesis remains uncertain. However, the clinical features of this neoplasm are very characteristic and SPTP must be suspected in any young woman with a cystic or partially cystic pancreatic mass. In this report, we describe the cytologic features of seven cases of SPTP investigated by preoperative fine-needle aspirates. The analysis of the cytologic features in these cases and in 43 cases collected from the literature reveals that they are highly characteristic and quite distinct from those of other cystic or solid tumors of the pancreas. On this basis, a cytologic diagnosis of SPTP may be rendered with great confidence, not only in clinically typical examples, but also in unusual presentations, such as in older patients, in males, in ectopic locations, and in metastatic sites. Copyright 2002 Wiley-Liss, Inc.
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              Clinical features and outcome of solid pseudopapillary neoplasm: differences between adults and children.

              To delineate the clinical and pathological characteristics of solid pseudopapillary neoplasm (SPN), compare them between adults and children, and determine the predictive features suggesting malignant potential. Retrospective analysis of patients who underwent surgery for a pathologically confirmed SPN. Tertiary care referral center. Sixty-two consecutive patients who underwent surgery for a pathologically confirmed SPN between 1985 and 2006. Demographic information and clinical presentation, radiological details, surgical data, pathological characteristics, postoperative course, and long-term survival. Among 62 patients, 47 patients were adults (mean age, 36 years; range, 18-63 years) and 15 patients were children (mean age, 12 years; range, 8-13 years). A palpable mass was the most common presenting symptom in children (9 of 15; 60%) and an incidentally detected pancreatic mass, in adults (18 of 47; 38.3%) (P = .001). The mean tumor size in children was significantly larger than in adults (8.0 vs 6.0 cm; P < .03). In children, the tumor was located in the head of the pancreas (10 of 15; 66.7%) and in adults, in the body or tail (38 of 47; 80.9%) (P = .001). Nine patients (14.5%) had malignant SPN. There was no significant clinical factor suggesting malignant potential. Two patients had a tumor recurrence. They were still alive after debulking surgery. There were no tumor-related deaths. Solid pseudopapillary neoplasm had different clinical features in adults and children. Because long-term survival can be achieved, even with the synchronous or metachronous metastatic lesions, SPN should be treated aggressively, with complete resection, even if this requires metastatectomy.
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                Author and article information

                Contributors
                Journal
                World J Surg Oncol
                World J Surg Oncol
                World Journal of Surgical Oncology
                BioMed Central
                1477-7819
                2013
                6 February 2013
                : 11
                : 38
                Affiliations
                [1 ]Department of Surgery, the Second Affiliated Hospital of JiaXing Medical College, JiaXing, 314000, China
                [2 ]Department of Abdominal Surgery, Zhejiang Cancer Hospital, 38# Guangji Road, Zhejiang Province, Hangzhou, 310022, China
                Article
                1477-7819-11-38
                10.1186/1477-7819-11-38
                3579726
                23384084
                bfbff2b1-51a7-4d41-a0e0-079aaca9437b
                Copyright ©2013 Wang et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 November 2012
                : 11 January 2013
                Categories
                Research

                Surgery
                Surgery

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