Solid pseudopapillary tumor of the pancreas in children: surgical intervention strategies based on pathological findings.
OBJECTIVE
The appropriate surgical intervention strategies for solid pseudopapillary tumor (SPT) of the pancreas in children are still controversial. The aim of this study was to establish surgical intervention strategies based on the pathological findings.


METHODS
We retrospectively reviewed the medical records of patients who underwent surgery for SPT between January 1994 and April 2013.


RESULTS
Five patients with SPT were identified. Tumors were located in the pancreatic head (n = 1), body (n = 2) and tail (n = 2). One patient showed spleen, liver and lung metastases. All five patients underwent pancreatectomy. Enucleation was not performed. One patient with metastases underwent partial hepatectomy. Four tumors had infiltration into the adjacent pancreatic parenchyma. The main pancreatic duct was incorporated into the tumor capsule wall in two patients. Surgical margins were negative in all patients without metastases. The median follow-up period was 37.8 months (range 7-74 months). One patient with metastases died at 60 months after surgery. All other patients were alive and showed no evidence of recurrence.


CONCLUSIONS
Radical resection with negative margins should be performed for SPT. From the perspective of curability, we suggest that pancreatectomy is the first choice for SPT in children.
Department of Pediatric surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, Shizuoka, 420-8660, Japan, keimorita1209@gmail.com.
Keiichi
K
Morita
Naoto
N
Urushihara
Koji
K
Fukumoto
Go
G
Miyano
Masaya
M
Yamoto
Hiroshi
H
Nouso
Hiromu
H
Miyake
Masakatsu
M
Kaneshiro
D000293:Adolescent; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D010179:Pancreas / Q000000981:diagnostic imaging / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013160:Splenic Neoplasms / Q000556:secondary; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome