Objective: To study the clinical manifestations, diagnosis, and treatment of solid and cystic tumor of pancreas (SCTP).
Methods: The clinical data, including clinical manifestations, imaging examination, pathology, and methodology and effect of surgical treatment, of 14 children with SCTP, one boy and 13 girls, aged 9 approximately 14, admitted to Beijing Children's Hospital November 1985 approximately March 2002 were collected and analyzed.
Results: The symptoms included abdominal pain (64.3%, 9/14), abdominal mass (50%, 7/14), and jaundice (21.4%, 3/14). The levels of alpha-fetoprotein, carcinoembryonic antigen, and CA199 were normal. Test of neuron specific enolase (NSE) made in 2 patients (a 10-year girl and a 13-year girl) showed increased levels (267.4 micro g/ml and 124 micro g/ml). Test of estrogen (E(2)) made in these 2 patients showed increased levels (0.3 ng/ml and 42.7 ng/ml) too. Test of lactate dehydrogenase (LDH) was made in one case and showed an increased level. Ultrasonography and CT scanning showed a round and well-circumscribed mass in the pancreas, 3 approximately 15 cm in diameter and with a little calcification, 7 masses in the head of pancreas, 3 in the body, and 2 in the tail. Local resection was performed on 2 patients and the other 12 underwent radical surgery with total splenectomy (4 cases) or partial splenectomy (1 case). Local infiltration was seen in only one case. One week after the operation the NSE level decreased to normal (9.5 micro g/ml and 8.7 micro g/ml) and the E(2) level decreased by more than 50% (17.5 ng/ml and 20.7 ng/ml) in the 2 patients. Follow-up of one month to 16 years showed that all patients survived without recurrence and metastasis.
Conclusion: SCTP, a rare tumor with low malignancy or a bordering tumor, is mostly seen in teenage girls. Imaging examination is helpful in diagnosis. Radical surgery is the best choice.