title: Solid-pseudopapillary neoplasm of the pancreas in children: can we predict malignancy?
abstract: OBJECTIVE
  We aimed to review clinical and histologic findings of solid-pseudopapillary neoplasm (SPN) in children and determine the predictive factor of the malignancy.
  
  
  METHODS
  The records of 45 patients (9 males, 36 females) who underwent surgery for SPN in the Asan Medical Center from 1992 to 2012 were retrospectively analyzed. We analyzed the factors between histologic benign group (n=36) and malignant group (n=9).
  
  
  RESULTS
  The mean age of children was 14.9±3.15years (range 9-20years). Mean size of the tumor was 6.36±3.61cm, and most common site in the pancreas was the tail (n=23). Three patients had distant metastasis at initial diagnosis. The sites were the liver (n=2) and the omentum (n=1). All patients underwent complete resection, and the median follow up period was 34months. Recurrence (n=4) was more common in the malignant group (p<0.05). We calculated the proportion of solid component by manual volumetry with a CT scan. The median value was 41.5% in benign group and 88.4% in malignant group. On comparative analysis, the proportion of solid component was found to have significant association with malignancy (p<0.05).
  
  
  CONCLUSIONS
  Histologic malignant SPN has high risk of recurrence. We should consider more radical resection when finding a predominantly solid tumor in a CT scan.
authors.affiliation: Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Jihee
authors.initials: J
authors.lastname: Hwang
authors.affiliation: Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. Electronic address: kimdy@amc.seoul.kr.
authors.forename: Dae Yeon
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Seong Chul
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Jung-Man
authors.initials: JM
authors.lastname: Namgoong
authors.affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Seung-Mo
authors.initials: SM
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009852:Omentum / Q000473:pathology; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010534:Peritoneal Neoplasms / Q000556:secondary; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Children; Malignancy; Recurrence; Solid-pseudopapillary neoplasm