Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
World Journal of Surgery
Published in: World Journal of Surgery 5/2007

Open Access 01-05-2007

Management of Solid-pseudopapillary Neoplasms of the Pancreas: a Comparison with Standard Pancreatic Neoplasms

Authors: S. M. M. de Castro, MD, D. Singhal, MD, D. C. Aronson, MD, O. R. C. Busch, MD, T. M. van Gulik, MD, H. Obertop, MD, D. J. Gouma, MD

Published in: World Journal of Surgery | Issue 5/2007

Login to get access

Abstract

Background

Solid-pseudopapillary neoplasms (SPNs) of the pancreas are increasingly diagnosed, but the exact surgical management in terms of extent of the resection is not well defined.

Materials and Methods

Patients operated on in our hospital between January 1993 and March 2005 formed the study groups.

Results

From 659 consecutive resections for pancreatic neoplasms, 12 female patients (1.8%) with a median age of 21 years who underwent resection for (SPN) are compared with the remaining 647 pancreatic resection patients. Jaundice (SPN 0 versus PR 73%, p < 0.001) and weight loss (SPN 0 versus PR 49%, p = 0.001) occurred significantly less often. Neoplasms were distributed equally among the pancreatic head (SPN 5 out of 12 patients versus PR 88%, p < 0.001) and corpus/tail (SPN 6 out of 12 patients versus PR 8%, p < 0.001). The operative time was significantly shorter (SPN 233 min versus PR 280 min, p = 0.012), and there were significantly fewer complications (SPN 1 of 12 patients versus PR 48%, p = 0.007). The mortality was not different (SPN 0 versus PR 1.6%, p = 1.000), and the hospital stay was significantly shorter (SPN 9 days versus PR 15 days, p = 0.012). The median size of the neoplasms was significantly larger (SPN 6.9 cm versus PR 2.5 cm). The median number of lymph nodes harvested was significantly fewer (SPN 1 versus PR 6, p = 0.001), and lymph node metastases occurred significantly less often (SPN 0 versus PR 64%, p < 0.001). The 5-year survival of SPN patients was 100% and is significantly better compared with survival of patients with pancreatic adenocarcinoma (12%, p < 0.001) and ampulla of Vater adenocarcinoma (22%, p = 0.005).

Conclusions

Patients with solid-pseudopapillary neoplasms of the pancreas present differently and the course of the disease is more benign. These patients can be adequately managed by pylorus-preserving pancreatoduodenectomy or spleen-preserving distal pancreatectomy with excellent early and long-term results.
Literature
1.
Frantz VK. Atlas of Tumor Pathology. Washington, DC, Armed Forces Institute of Pathology, 1959
2.
Hamoudi AB, Misugi K, Grosfeld JL, et al. Papillary epithelial neoplasm of pancreas in a child. Report of a case with electron microscopy. Cancer 1970;26:1126–1134
3.
Sarr MG, Warshaw AL. Tumor versus neoplasm: Isn’t it time to use the correct term—neoplasm? Surgery 2005;137:297CrossRefPubMed
4.
Mao C, Guvendi M, Domenico DR, et al. Papillary cystic and solid tumors of the pancreas: a pancreatic embryonic tumor? Studies of three cases and cumulative review of the world’s literature. Surgery 1995;118:821–828CrossRefPubMed
5.
Bardales RH, Centeno B, Mallery JS, et al. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid-pseudopapillary tumor of the pancreas: a rare neoplasm of elusive origin but characteristic cytomorphologic features. Am J Clin Pathol 2004;121:654–662CrossRefPubMed
6.
Martin RC, Klimstra DS, Brennan MF, et al. Solid-pseudopapillary tumor of the pancreas: a surgical enigma? Ann Surg Oncol 2002;9:35–40CrossRefPubMed
7.
Klimstra DS, Wenig BM, Heffess CS. Solid-pseudopapillary tumor of the pancreas: a typically cystic carcinoma of low malignant potential. Semin Diagn Pathol 2000;17:66–80PubMed
8.
Panieri E, Krige JE, Bornman PC, et al. Operative management of papillary cystic neoplasms of the pancreas. J Am Coll Surg 1998;186:319–324CrossRefPubMed
9.
Lam KY, Lo CY, Fan ST. Pancreatic solid-cystic-papillary tumor: clinicopathologic features in eight patients from Hong Kong and review of the literature. World J Surg 1999;23:1045–1050CrossRefPubMed
10.
Jung SE, Kim DY, Park KW, et al. Solid and papillary epithelial neoplasm of the pancreas in children. World J Surg 1999;23:233–236CrossRefPubMed
11.
Tipton SG, Smyrk TC, Sarr MG, et al. Malignant potential of solid pseudopapillary neoplasm of the pancreas. Br J Surg 2006;93:733–737CrossRefPubMed
12.
Gouma DJ, van Geenen RC, van Gulik TM, et al. Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume. Ann Surg 2000;232:786–795CrossRefPubMed
13.
Berge Henegouwen MI, de Wit LT, van Gulik TM, et al. Incidence, risk factors, and treatment of pancreatic leakage after pancreaticoduodenectomy: drainage versus resection of the pancreatic remnant. J Am Coll Surg 1997;185:18–24PubMed
14.
Buetow PC, Buck JL, Pantongrag-Brown L, et al. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology 1996;199:707–711PubMed
15.
Cantisani V, Mortele KJ, Levy A, et al. MR imaging features of solid pseudopapillary tumor of the pancreas in adult and pediatric patients. AJR Am J Roentgenol 2003;181:395–401PubMed
16.
Mergener K, Detweiler SE, Traverso LW. Solid pseudopapillary tumor of the pancreas: diagnosis by EUS-guided fine-needle aspiration. Endoscopy 2003;35:1083–1084CrossRefPubMed
17.
Rothmund M, Angelini L, Brunt LM, et al. Surgery for benign insulinoma: an international review. World J Surg 1990;14:393–398CrossRefPubMed
18.
Efron DT, Lillemoe KD, Cameron JL, et al. Central pancreatectomy with pancreaticogastrostomy for benign pancreatic pathology. J Gastrointest Surg 2004;8:532–538CrossRefPubMed
19.
Warshaw AL. Conservation of the spleen with distal pancreatectomy. Arch Surg 1988;123:550–553PubMed
20.
Zinner MJ, Shurbaji MS, Cameron JL. Solid and papillary epithelial neoplasms of the pancreas. Surgery 1990;108:475–480PubMed
21.
Rebhandl W, Felberbauer FX, Puig S, et al. Solid-pseudopapillary tumor of the pancreas (Frantz tumor) in children: report of four cases and review of the literature. J Surg Oncol 2001;76:289–296CrossRefPubMed
22.
Nishihara K, Nagoshi M, Tsuneyoshi M, et al. Papillary cystic tumors of the pancreas. Assessment of their malignant potential. Cancer 1993;71:82–92CrossRefPubMed
Metadata
Title
Management of Solid-pseudopapillary Neoplasms of the Pancreas: a Comparison with Standard Pancreatic Neoplasms
Authors
S. M. M. de Castro, MD
D. Singhal, MD
D. C. Aronson, MD
O. R. C. Busch, MD
T. M. van Gulik, MD
H. Obertop, MD
D. J. Gouma, MD
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 5/2007
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-006-0214-2

Other articles of this Issue 5/2007

World Journal of Surgery 5/2007 Go to the issue

OriginalPaper

A New Hormonal Therapy for Estrogen Receptor–Negative Breast Cancer

OriginalPaper

Spectrum of Breast Cancer in Asian Women

OriginalPaper

Evidence-based Approach to the Management of Sporadic Medullary Thyroid Carcinoma

OriginalPaper

Transient Liver Dysfunction after Laparoscopic Gastrectomy for Gastric Cancer Patients

OriginalPaper

Portal Venous Gas Detected on Computed Tomography in Emergency Situations: Surgery Is Still Necessary

OriginalPaper

Surgical Options in Undifferentiated Thyroid Carcinoma