Solid-pseudopapillary Tumor Of The Pancreas: Clinical Analysis Of19Cases

Background solid-seudopapillary tumor of panereas(SPT) was one of rare pancreaticneoplasm,and was first reported by Frantz in1959.So It was called Frantz tumor.Scholarsaccording to the characteristics of the macromorphology and pathology,the diagnosis has beencalled many different names,e.g.solid papillary epithelial tumor,solid-cystic tumor,papillarycystic tumor,solid-cystic papillary tumor of acinar cells,etc.In1996,the World Heathorganization named it as solid-pseudopapillary tumor of pancreas.SPT is a rare tumor and theincidence rate of it in all pancreatic tumors account for0.13%to2.7%, affecting primarilyyoung women. The disease usually is binign and only scantyly behave malignant.The result ofsurgical resection is mostly favorable.In recent years,with the in-depth understanding of SPT,clinical diagnosis of the disease has gradually increased.But it is still easily misdiagnosed.Evento give up the operation just because the tumor is too huge.To further thoroughly know thisdisease,and simultaneously to discuss the characteristic clinical manifestion and the besttreatment of SPT,to provide some reference fou this disease's diagnosis and therapy.Clinicaldata of the19patients with SPT of this article treated at the first hospital of ShanXi medicaluniversity from January2003to August2011were reviewed.To retrospectively analyse andsummarize the characteristics of the data.Objective:To discuss the clinical manifestations,diagnosis,treatment and prognosis of SPT,to improve the understanding of the disease.Methods: Clinical data of the19patients with SPT treated at the first hospital of ShanXimedical university from January2003to August2011were reviewed. To retrospectivelyanalyse and summarize the characteristics of the data.Results:19patients on average age of25.8years(ranged from11to56years),three weremale,the others were female.The clinical presentations included palpable abdominal mass inseven patients and abdominal distention and pain in another four.Eight patients wereasymptomatic;their tumors were found incidentally by abdominal ultrasonic examination.Fasting plasma glucose,amylase, lipase, billirubin,tumor markers of these patients were innormal range. All the patients were treated surgically. Five patients underwentpancreatoduodenectomy. Three patients underwent simple tumor resection. Four patientsunderwent distal pancreatectomy. Six patients underwent distal pancreatectomy plus spleenresection.The average diameter of the tumors in the nineteen cases was8.1cm.The nine patientsdeveloped postoperative pancreatic fistula, and all were cured well by symptomatic treatment. Seventeen patients were followed up.The follow-up time ranged from3-70months.No evidenceof recurrence and metastasis appeared during the follow-up period.Conclusions:Solid-pseudopapillary tumor of pancreas is a rare tumor with low malignantpotential, affecting mainly young women.The tumor may appear any part of the pancreas,evenbeyond the pancreas,The volume of the tumor is mostly large and has an envelope.The tumorwon't cause an obstruction of the pancreatic duct and the billiary tract.Most of the patients wereasymptomatic. Imaging techniques including B ultrasound, CT and MRI could prompt thedisease.B ultrasound or CT guided preoperative abdominal fine-needle aspirates biopsy couldconfirm the diagnosis.Surgical resection is mostly curative and has a favorable prognosis è eventhe local metastasis appeared or the tumor has invaded the liver.Postoperative patients shouldbe closely followed è especially for the patients with significant invasion had be found bypathological examination.