Solid-pseudopapillary tumor of the pancreas: clinical experience and literature review.
OBJECTIVE
To evaluate the clinical presentations of solid-pseudopapillary tumor of the pancreas (SPT) and examine the diagnosis, treatment, low grade malignant potential of this rare disease.


METHODS
We retrospectively reviewed a series of seven patients with SPT managed in our hospital between July 1990 and October 2003. Six females and one male with mean age of 31 years (range 13 to 50 years) were diagnosed with SPT at our institution.


RESULTS
Clinical presentation included a palpable abdominal mass in two patients and vague abdominal discomfort in another two. Two patients were asymptomatic; their tumors were found incidentally on abdominal sonographic examination for other reasons. The final patient was admitted with hemoperitoneum secondary to tumor rupture. The mean diameter of the tumors in the seven patients was 10.5 cm (range 5 to 20 cm). The lesions were located in the body and tail in five cases and in the head of the pancreas in two. Surgical procedures included distal pancreatectomy (3), distal pancreatectomy with splenectomy (2), pancreaticoduodenectomy (1) and a pylorus-preserving Whipple procedure (1). There were gross adhesions or histological evidence of infiltration to the adjacent pancreas and/or splenic capsule in four cases. None of the patients received adjuvant therapy. The mean follow up was 7 years (range 0.5 to 14 years). One patient developed multiple liver metastases after 14 years of follow up.


CONCLUSIONS
SPT is a rare tumor that behaves less aggressively than other pancreatic tumor. However, in cases with local invasion, long-term follow up is advisable.
Huang
Hsueh-Lien
HL
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine Nursing and Management College, Taipei, Taiwan, China.
Shih
Shou-Chuan
SC
Chang
Wen-Hsiung
WH
Wang
Tsang-En
TE
Chen
Ming-Jen
MJ
Chan
Yu-Jan
YJ
D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy