Solid pseudopapillary tumour of the pancreas: Incidence, prognosis and outcome of surgery (single center experience)

Abstract

Background: Solid pseudopapillary tumour (SPT) of the pancreas is a rare neoplasm of low malignant potential. The pathogenesis and guidelines for its treatment remain unclear. This study was designed to evaluate the diagnosis, surgical treatment and prognosis of SPT.

Study design: A retrospective study during the period between January 1995 to October 2012.

Patients and method: Cases with SPTs treated at our institution were reviewed. Demographic data, clinical manifestations, radiological, surgical, and pathological records were reviewed for patients with SPT.

Results: Twenty four patients with SPT were identified (22 women and 2 men with a mean age 24.83 ± 8.66 (12-52 years). The tumour was located in the head in (50%) and in the body (8.3%) and in the tail (41.7%). The mean size was 9.2 ± 5.3 (3-25 cm). The main clinical presentation was abdominal pain in (83.3%). All 24 patients had curative resection including pancreaticoduodenectomy (50%), central pancreatectomy (8.3%) and distal pancreatectomy (41.7%). Sex, age, symptoms, tumour size, CT image and tumour markers were not significant clinical factors to predict SPT with malignant behavior. The recurrence rate was (8.3%) after 5 years postoperatively. No hospital mortality, all patients except 2 patients (8.3%) were alive at follow up period. The estimated 1, 3, and 5 year survival rate was 95%, 95%, and 88%.

Conclusion: SPT are rare neoplasms with malignant potential. Aggressive surgical resection is needed even in presence of local invasion, and also for recurrence as patients had a good long term survival.