title: Solid pseudopapillary neoplasms of the pancreas: an 18-year experience at a single Japanese Institution.
abstract: OBJECTIVE
  This study investigated the clinicopathological features and surgical management of solid pseudopapillary neoplasms at a single institution in Japan.
  
  
  METHODS
  Seventeen patients (the largest series in Japan) those underwent surgery for pathologically confirmed solid pseudopapillary neoplasms were retrospectively reviewed.
  
  
  RESULTS
  Sixteen patients were women and their mean age was 34.1 years. Most patients were asymptomatic (n = 11), and the average tumor diameter was 51.8 mm. The most common imaging characteristic was tumors of solid and cystic type (n = 10), which were most commonly located in the pancreatic body (n = 7). All patients underwent surgical exploration, i.e., distal pancreatectomies in 7 patients (laparoscopically performed in 2); middle pancreatectomies, 4; pancreaticoduodenectomies, 4; enucleation, 1; and liver resection, 1. No surgical mortalities occurred, and postsurgical complications occurred in 9 patients. Four patients had malignant tumors. One patient with liver metastases experienced recurrence, which was well controlled by paclitaxel. The remaining patients were disease free at a median follow-up of 51 months.
  
  
  CONCLUSIONS
  Solid pseudopapillary neoplasms can be treated by complete tumor resection with limited resection or a minimally invasive approach when applicable. The combination of surgical resection and chemotherapy may therefore prolong survival, even in malignant cases.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Morikawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Onogawa
authors.forename: Shimpei
authors.initials: S
authors.lastname: Maeda
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Takadate
authors.forename: Keiichi
authors.initials: K
authors.lastname: Shirasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishida
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Naitoh
authors.forename: Toshiki
authors.initials: T
authors.lastname: Rikiyama
authors.forename: Yu
authors.initials: Y
authors.lastname: Katayose
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult