Surgical outcome of solid pseudopapillary tumor of the pancreas.
OBJECTIVE
The best surgical treatment for solid pseudopapillary tumor of the pancreas is a matter of debate.


METHODS
Fourteen patients with solid pseudopapillary tumor of the pancreas who underwent surgical resection, including enucleation, between June 1996 and January 2007 were retrospectively analyzed to evaluate the effect of the treatment.


RESULTS
The mean age of the patients was 39 years (range, 15 to 59 years). The mean size of the tumor was 4.4 cm (range, 2.0 to 12 cm). Ten tumors (71%) had a well-defined capsule, and 6 tumors (43%) extended beyond the pancreas. Eight of the 14 tumors (57%) had a cystic component, and calcification was observed in 6 tumors (43%). The frequency of microscopic venous invasion, lymphatic invasion, and nerve invasion was 29% (4 of 14), 0%, and 21% (3 of 14), respectively. No lymph node involvement or liver metastasis was observed. Six patients underwent positron emission tomography with 2-deoxy-2-[(18)F] fluoro-D-glucose (FDG), and stronger FDG accumulation compared with the surrounding pancreatic parenchyma was observed in 5 of the 6 patients. The median standardized uptake value (SUV) was 6.3 (range, 0.9 to 42.8). Distal pancreatectomy (n = 5), subtotal stomach-preserving pancreatoduodenectomy (n = 3), local resection (n = 3), enucleation (n = 2), and duodenum-preserving pancreatic head resection (n = 1) were performed. Overall morbidity and mortality rates were 43% and 0%, respectively. All patients were still alive without recurrent disease after a median follow-up of 46 months.


CONCLUSIONS
Patients with solid pseudopapillary tumor of the pancreas had a favorable outcome after surgical treatment, including enucleation.
Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan.
Toshio
T
Nakagohri
Taira
T
Kinoshita
Masaru
M
Konishi
Shinichirou
S
Takahashi
Naoto
N
Gotohda
D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011877:Radionuclide Imaging
D019788:Fluorodeoxyglucose F18