title: Solid-pseudopapillary tumours of the pancreas: 14 years experience.
abstract: BACKGROUND
  Solid-pseudopapillary tumour of the pancreas (SPTP) is a low-grade malignancy lesion that is distinct from other pancreatic tumours. Preoperative diagnosis is often inaccurate and treatment strategies remain controversial. The present study reviews the clinical features, diagnosis, treatment, and outcome of Asian patients with SPTP from a single institution.
  
  
  METHODS
  The medical records and images of patients who underwent surgery for SPTP between June 1990 and December 2003 were retrospectively reviewed. Study eligibility required that patients had undergone surgical resections and that the SPTP had been pathologically demonstrated.
  
  
  RESULTS
  Twenty-eight patients with SPTP were identified. Eighteen patients (64.3%) reported the predominant symptom of 'vague abdominal pain', five patients (17.8%) had an apparent 'abdominal mass', and five patients (17.8%) without overt symptoms had masses that were discovered incidentally during screening. All patients underwent magnetic resonance (MR) imaging (n = 22) and/or computed tomography (n = 17), with a specificity of 90.9% and 76.4%, respectively. All masses were well-circumscribed, except for a tumour in one patient (3.6%), which adhered to the stomach wall and metastasized to the liver. Two patients (7.1%) underwent enucleation, while 25 patients (89.3%) received curative resection. The patient with the liver metastases underwent distal pancreatectomy and splenectomy with partial hepatectomy. The mean follow up was 66.9 months. No mortality occurred during follow up but the patient with the liver metastasis had progressive deterioration.
  
  
  CONCLUSIONS
  Symptoms of SPTP are indistinct and preoperative diagnosis is often inaccurate. Magnetic resonance imaging improves SPTP diagnosis. In general, the prognosis of well-circumscribed SPTP is favourable after curative resection.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. sunchuandong@sohu.com
authors.forename: Chuan-Dong
authors.initials: CD
authors.lastname: Sun
authors.forename: Woo-Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Jin-Suob
authors.initials: JS
authors.lastname: Choi
authors.forename: Jung-Tak
authors.initials: JT
authors.lastname: Oh
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed