Childhood pancreatic tumors: a single institution experience.
OBJECTIVE
The rarity and histopathologic diversity of primary pancreatic neoplasms in children have made it difficult to predict prognosis and to develop optimal management protocols.


METHODS
A 90-year (1918-2007), single institution, retrospective review of all patients with neoplastic pancreatic masses was performed.


RESULTS
Eighteen patients were identified with 7 distinct histopathologic subtypes. The most common were gastroenteropancreatic neuroendocrine, solid pseudopapillary, and acinar tumors. There were 6 benign and 12 malignant tumors. Six patients had disease outside the pancreas at their initial operation. There were 7 deaths (41%), 2 related to the initial operation, 3 from disease progression, 1 from a small bowel obstruction, and 1 from necrotizing pancreatitis. Five deaths were in patients with extrapancreatic disease found at initial operation. The median duration of follow-up for the 10 survivors was 41 months.


CONCLUSIONS
In adults, pancreatic ductal adenocarcinoma is by far the most common histopathologic subtype, with other subtypes more common in children. Stage is an important prognostic factor. Long-term disease-free survival in childhood pancreatic malignancies is achievable with complete surgical resection, prognosis, and adjuvant treatment, depending on the histopathologic type.
Yu
David C
DC
Department of Pediatric Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA, 02115, USA.
Kozakewich
Harry P
HP
Perez-Atayde
Antonio R
AR
Shamberger
Robert C
RC
Weldon
Christopher B
CB
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018291:Cystadenoma, Mucinous / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000175:diagnosis / Q000473:pathology / Q000601:surgery