title: Clinical and biological behavior of pancreatic solid pseudopapillary tumors: report on 31 consecutive patients.
abstract: BACKGROUND
  Solid pseudopapillary tumors (SPTs) represent one of the most uncommon histotypes of all exocrine pancreatic neoplasms.
  
  
  OBJECTIVE
  To delineate the clinical presentation and biological behavior of SPT and evaluate the efficacy of treatment.
  
  
  METHODS
  Retrospective analysis of 31 patients (27 female, 4 male, mean age of 34 years, (range 7-56)) who underwent surgical resection with a definitive histological diagnosis of SPT.
  
  
  RESULTS
  Tumor detection was incidental in the 55% of cases. Symptoms were abdominal discomfort (n=10), jaundice (n=2), weight loss (n=6), vomiting (n=5), and a palpable abdominal mass (n=4). The neoplasm was localized in the pancreatic head in 10 patients and in the body-tail in 20 cases; the main diameter ranged from 2 to 20 cm (mean 5.4). At the radiological work-up, the neoplasm was solid in 87% of cases and delimited by a capsule in 39%. An internal necrotic-hemorrhagic area was present in 29% of cases. Calcifications were noticed in two patients and septa in one. None of the patients had metastases at the time of diagnosis. In 9 cases, pancreaticoduodenectomy was performed, while 15 patients underwent a left pancreatectomy (4 spleen preserving), 6 a middle pancreatectomy, and 1 enucleation. There was no postoperative mortality with an overall morbidity of 35%. At a median follow-up of 58.2 months (12-229 range), all patients are alive without evidence of local recurrence, metastasis, diabetes, or exocrine insufficiency.
  
  
  CONCLUSIONS
  Solid pseudopapillary tumor (SPT) is an indolent neoplasm with low-grade biological aggressiveness, making surgical treatment successful despite its large size.
authors.affiliation: Department of Surgery, University of Verona, GB Rossi Hospital, Verona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Leonardina
authors.initials: L
authors.lastname: Festa
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
authors.forename: Stefano
authors.initials: S
authors.lastname: Crippa
authors.forename: Giovanni
authors.initials: G
authors.lastname: Butturini
authors.forename: Antonietta
authors.initials: A
authors.lastname: Brighenti
authors.forename: Paola
authors.initials: P
authors.lastname: Capelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Pederzoli
mesh_terms: D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies