The Diagnosis And Treatment Of Solid-pseudopapillary Tumor Of The Pancreas: A Review Of Literatures In China

Aim: Solid-pseudopapillary tumors (SPT) of the pancreas are rare. It is of low malignant potential and occurs mainly in young females. Frantz et al. reported first 4 cases of SPT in 1959. This study was designed to summarize clinical experience of solid-pseudopapillary (SPT) in China and define the clinicopathological characteristics and the effect of surgical intervention.Methods: The clinical data of 93 patients with SPT reported in Chinese review including those in our hospital were analyzed, retrospectively.Results: 84 females and 9 males were identified, with a mean age 25.8 (range 9-67) years. The predominant cause for visiting hospital included uncharacteristic abdominal pain (52.4%), presentation with a palpable abdominal mass (39.0%), vomit and nausea (19.5%), abdominal distention (13.4%), jaundice (2.4%), etc. The mean tumor diameter was 7.9 cm (range 2-20 cm). 38 tumors located in the head, 24 in the body, 31 in the tail of pancreas. 4 cases were found to be of metastasis in abdominal and pelvic cavity. The serum tumor markers were negative in all cases. Surgical resection was performed in all cases. The types of resection were simple tumorectomy (41.9%), distal pancreatectomy (34.4%; 85.8% combined with splenectomy), pancreaticoduodenectomy (19.4%) and extensive radical resection (4.3%). Histological examination showed cystic-solid (50%), cystic (18.8%) or solid (31.2%) appearance. Most of tumors (92.1%) had complete capsule. Microscopy showed papillary protrusion of epithelium above fibrovascular stalks, which was characterized by a rich and delicate vascular network. No recurrence was found in the 7 patients of our hospital according to the follow-up from 3 months to 39 months.Conclusions: SPT should be concerned with the presentation ofabdominal pain and/or mass in adolescent girls and young adult females, cystic and/or solid appearance in CT scan or B ultrasound and negative serum tumor markers. Radical resection should be performed if possible. The evaluations of pre-operative diagnosis and prognosis need further research.