title: Peripancreatic lymphadenopathy on preoperative radiologic images predicts malignancy in pancreatic solid pseudopapillary neoplasm.
abstract: OBJECTIVE
  To identify clinicopathological characters and risk factors of malignant pancreatic solid pseudopapillary neoplasm (SPN).
  
  
  METHODS
  All patients with complete clinicopathological records who underwent surgery for SPN between 2000 and 2010 were retrospective reviewed. Furthermore, we reviewed and classified the histopathology slides of all patients according to the 2010 World Health Organization criteria.
  
  
  RESULTS
  Of the 100 patients identified, 84 (84.0%) were female, and the median age was 31 (range, 13-68) years old. Median tumor size was 6.5 (range, 1.5-18) cm. Twenty-four patients (24.0%) were classified to have malignant SPN. Forty-nine patients had lymph node removed in surgery, and four (8.2%) had nodal metastases. On univariate analysis, peripancreatic lymphadenopathy on preoperative computed tomography (CT) and/or magnetic resonance (MR) images was significant risk factor of malignancy (P = 0.025). In the long-term follow up, two patients had evidence of liver metastases and underwent a second laparotomy for metastatic tumor. These two patients were followed up for 24 and 32 months respectively, and never presented with tumor recurrence again.
  
  
  CONCLUSIONS
  Peripancreatic lymphadenopathy on preoperative radiologic images was associated with malignancy in patients with SPN. Close follow-up and review periodically were recommended for patients with malignant SPN.
authors.affiliation: Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Che
authors.affiliation: Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China.
authors.forename: Yingtai
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College Beijing, China.
authors.forename: Chengfeng
authors.initials: C
authors.lastname: Wang
keywords: Pancreas; malignant tumor; solid pseudopapillary neoplasm; surgery