Pancreatic solid-cystic papillary tumor: clinical features, imaging findings and operative management.
Solid-cystic papillary tumors of the pancreas are very rare and, until today, 718 cases have been reported in a review of the literature. Four patients affected by solid-cystic papillary tumors, observed in our Institute between January 1985 and July 2005, are reported. The clinicopathological, operative and survival data of this tumor were reviewed comparing our experience with a review of the literature. Solid-cystic papillary tumor have a preference for young women (age between 19-50 yrs) and show a large round, well-defined pancreatic mass(greater than 5 cm), clinically silent or with unspecific symptoms. The tumor is more frequently localized in the pancreas (80%) and is rarely a metastatic disease (20%). Surgical treatment with radical pancreatic resection of the tumor was performed in approximately 95% of the cases. In 467 patients, two-year survival was 97% (16 deaths) and 5-year survival was 95% (21 deaths). In conclusion, preoperative diagnosis of solid-cystic tumors of the pancreas is difficult but knowledge of its characteristic findings can aid in reaching a proper diagnosis. Surgery is the treatment of choice; it should be conservative in localized tumors, and aggressive, in non-localized tumors. The prognosis is very good, with long-term survival also in patients with metastases or unresectable tumors.
Casadei
Riccardo
R
Department of Surgery, S.Orsola-Malpighi Hospital, Bologna, Italy. casadei@aosp.bo.it
Santini
Donatella
D
Calculli
Lucia
L
Pezzilli
Raffaele
R
Zanini
Nicola
N
Minni
Francesco
F
D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome