The prognosis and clinical characteristics of advanced (malignant) solid pseudopapillary neoplasm of the pancreas.

Until today, there is no consistency about the prognosis and the diagnostic criteria of the "malignant" pancreatic solid pseudopapillary neoplasms (m-SPNs). We here made a retrospective study of 26 such cases and try to give a comprehensive description of their pathological characteristics and clinical course. We found out that among those malignant cases, the most common involved extrapancreatic organ was the duodenum, followed by the spleen and the portal vein. The lymph node and the liver metastasis were also seen in 19 % cases, respectively. Most of the patients were female (22/26). Calcification, foamy cytoplasm, and bizarre nuclei of tumor cells were more common in male patients. Every patient underwent surgical resection and had excellent prognosis. There were two patients who had metastasis to the liver 6 years after excision. The recurrence status correlated with the family history of malignant tumor. No patient died of the disease directly during the mean follow-up time of 73.9 months (21-135 months). Our results supported the idea that the prognosis of the advanced stage SPNs was excellent. The surgical resection seemed effectively enough for these patients. However, all the patients need close follow-ups, especially those who had family history of malignant tumors.