Keiji Hanada, Keisuke Kurihara1, Takao Itoi2, Akio Katanuma3, Tamito Sasaki4, Kazuo Hara5, Masafumi Nakamura6, Wataru Kimura7, Yutaka Suzuki8, Masanori Sugiyama8, Nobuyuki Ohike9, Noriyoshi Fukushima10, Michio Shimizu11, Kousei Ishigami12, Toshifumi Gabata13, Kazuichi Okazaki14. 1. Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima. 2. Department of Gastroenterology, Tokyo Medical University, Tokyo. 3. Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo. 4. Department of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima. 5. Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya. 6. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka. 7. Faculty of Medicine, First Department of Surgery, Yamagata University, Yamagata. 8. Department of Surgery, Kyorin University School of Medicine. 9. Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa. 10. Department of Pathology, Jichi Medical University, Tochigi. 11. Diagnostic Pathology Center, Hakujikai Memorial Hospital, Tokyo. 12. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka. 13. Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa. 14. Department of Gastroenterology, Kansai Medical University, Osaka, Japan.
Abstract
OBJECTIVE: The aim of this study was to evaluate the clinicopathological features of solid pseudopapillary neoplasms (SPNs). METHODS: In this retrospective study, 288 SPNs were analyzed. RESULTS: Overall, 214 patients (74%) were female. Distant metastases occurred in 4 patients, and splenic vein tumor thrombus occurred in 1 patient. Although imaging findings showed large (>2.0 cm) SPNs with clear, regular border, and heterogeneous internal structure, small SPNs appeared as almost entirely solid. Surgical resection was performed in 278 cases. The 5-year survival rate was 98.8%. Six patients had tumor recurrence after the initial resection. The detection rate in typical pathological findings was low for small SPNs. Tumor extension to the pancreatic parenchyma was detected in greater than 70% of the cases. Tumor invasion to adjacent organs was detected in 13 cases. One was given a diagnosis of apparent high-grade malignant transformation. CONCLUSIONS: The proportion of male cases was higher than that in previous studies, and there were statistically significant differences in the onset age and tumor diameter between male and female patients. Therefore, women seemed to have an early occurrence of SPNs, suggesting a difference in the developmental stage between men and women. Images and pathological findings of SPNs varied according to tumor size. Our findings indicated that SPN patients have excellent survival after margin-negative surgical resection.
OBJECTIVE: The aim of this study was to evaluate the clinicopathological features of solid pseudopapillary neoplasms (SPNs). METHODS: In this retrospective study, 288 SPNs were analyzed. RESULTS: Overall, 214 patients (74%) were female. Distant metastases occurred in 4 patients, and splenic vein tumor thrombus occurred in 1 patient. Although imaging findings showed large (>2.0 cm) SPNs with clear, regular border, and heterogeneous internal structure, small SPNs appeared as almost entirely solid. Surgical resection was performed in 278 cases. The 5-year survival rate was 98.8%. Six patients had tumor recurrence after the initial resection. The detection rate in typical pathological findings was low for small SPNs. Tumor extension to the pancreatic parenchyma was detected in greater than 70% of the cases. Tumor invasion to adjacent organs was detected in 13 cases. One was given a diagnosis of apparent high-grade malignant transformation. CONCLUSIONS: The proportion of male cases was higher than that in previous studies, and there were statistically significant differences in the onset age and tumor diameter between male and female patients. Therefore, women seemed to have an early occurrence of SPNs, suggesting a difference in the developmental stage between men and women. Images and pathological findings of SPNs varied according to tumor size. Our findings indicated that SPNpatients have excellent survival after margin-negative surgical resection.