title: Clinical features and outcome of solid pseudopapillary neoplasm: differences between adults and children.
abstract: OBJECTIVE
  To delineate the clinical and pathological characteristics of solid pseudopapillary neoplasm (SPN), compare them between adults and children, and determine the predictive features suggesting malignant potential.
  
  
  METHODS
  Retrospective analysis of patients who underwent surgery for a pathologically confirmed SPN.
  
  
  METHODS
  Tertiary care referral center.
  
  
  METHODS
  Sixty-two consecutive patients who underwent surgery for a pathologically confirmed SPN between 1985 and 2006.
  
  
  METHODS
  Demographic information and clinical presentation, radiological details, surgical data, pathological characteristics, postoperative course, and long-term survival.
  
  
  RESULTS
  Among 62 patients, 47 patients were adults (mean age, 36 years; range, 18-63 years) and 15 patients were children (mean age, 12 years; range, 8-13 years). A palpable mass was the most common presenting symptom in children (9 of 15; 60%) and an incidentally detected pancreatic mass, in adults (18 of 47; 38.3%) (P = .001). The mean tumor size in children was significantly larger than in adults (8.0 vs 6.0 cm; P < .03). In children, the tumor was located in the head of the pancreas (10 of 15; 66.7%) and in adults, in the body or tail (38 of 47; 80.9%) (P = .001). Nine patients (14.5%) had malignant SPN. There was no significant clinical factor suggesting malignant potential. Two patients had a tumor recurrence. They were still alive after debulking surgery. There were no tumor-related deaths.
  
  
  CONCLUSIONS
  Solid pseudopapillary neoplasm had different clinical features in adults and children. Because long-term survival can be achieved, even with the synchronous or metachronous metastatic lesions, SPN should be treated aggressively, with complete resection, even if this requires metastatectomy.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Hwang
authors.forename: Kwi-Won
authors.initials: KW
authors.lastname: Park
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult