BACKGROUND: The aim of this study was to identify clinical predictors of malignancy and surgical strategies for pancreatic solid pseudopapillary neoplasm (SPN) by analysis of surgical outcomes at a single institution. METHODS: All patients who underwent surgery for SPN between 1995 and 2010 were identified. Histopathology slides of all patients were reviewed by a specialized pathologist and the neoplasms were classified according to the criteria of the World Health Organization 2010. RESULTS: Of the 106 patients identified, 85 (80·2 per cent) were female, and the median age was 36 (range 10-65) years. Median tumour size was 4·5 (range 1·0-15·0) cm. Some 17 patients (16·0 per cent) were classified as having a high-grade malignant SPN. Tumour size of at least 5 cm was associated with high-grade malignant potential (P = 0·022). Although lymph nodes were removed from 40 patients (37·7 per cent), there were no nodal metastases. A total of five patients underwent en bloc resection of adjacent structures, including two with portal vein involvement. After a median follow-up of 56·9 months, two patients with high-grade malignant SPN had evidence of tumour recurrence in the lymph nodes and liver. CONCLUSION: SPN with a diameter of 5 cm or more is associated with a high-grade malignant phenotype. Complete surgical removal is associated with low recurrence rates.
BACKGROUND: The aim of this study was to identify clinical predictors of malignancy and surgical strategies for pancreatic solid pseudopapillary neoplasm (SPN) by analysis of surgical outcomes at a single institution. METHODS: All patients who underwent surgery for SPN between 1995 and 2010 were identified. Histopathology slides of all patients were reviewed by a specialized pathologist and the neoplasms were classified according to the criteria of the World Health Organization 2010. RESULTS: Of the 106 patients identified, 85 (80·2 per cent) were female, and the median age was 36 (range 10-65) years. Median tumour size was 4·5 (range 1·0-15·0) cm. Some 17 patients (16·0 per cent) were classified as having a high-grade malignant SPN. Tumour size of at least 5 cm was associated with high-grade malignant potential (P = 0·022). Although lymph nodes were removed from 40 patients (37·7 per cent), there were no nodal metastases. A total of five patients underwent en bloc resection of adjacent structures, including two with portal vein involvement. After a median follow-up of 56·9 months, two patients with high-grade malignant SPN had evidence of tumour recurrence in the lymph nodes and liver. CONCLUSION: SPN with a diameter of 5 cm or more is associated with a high-grade malignant phenotype. Complete surgical removal is associated with low recurrence rates.
Authors: Omar Picado; Anthony Ferrantella; Celisse Zabalo; Krishnamurti Rao; Chad M Thorson; Juan E Sola; Eduardo A Perez Journal: Pediatr Surg Int Date: 2020-01-27 Impact factor: 1.827
Authors: Alper Uğuz; Ömer Vedat Ünalp; Göksever Akpınar; Can Avni Karaca; Nevin Oruç; Deniz Nart; Funda Yılmaz; Ahmet Aydın; Ahmet Çoker Journal: Turk J Gastroenterol Date: 2020-12 Impact factor: 1.852
Authors: Maria G Sacco Casamassima; Colin D Gause; Seth D Goldstein; Fizan Abdullah; Avner Meoded; Jeffrey R Lukish; Christopher L Wolfgang; John Cameron; David J Hackam; Ralph H Hruban; Paul M Colombani Journal: Pediatr Surg Int Date: 2016-06-30 Impact factor: 1.827