Solid pseudopapillary tumor of the pancreas: Report of five cases

Abstract

Introduction: Solid pseudopapillary tumor of the pancreas (SPT) is a rare pancreatic tumor with an unclear pathogenesis and good prognosis after resection. We report our experience with the diagnostic and therapeutic management of these tumors over 10 years. Case Series: A retrospective chart review was performed for all patients undergoing pancreatic resection at our institution from 2001-2011. Patients with final pathology demonstrating SPT were identified. Of 617 pancreatic resections performed at our institution, five patients (0.8%) were found to have solid pseudopapillary tumor of the pancreas. All patients were female with a mean age of 39.2 years. Abdominal pain was the presenting symptom in four patients. MRI demonstrated pancreatic head involvement in three patients and pancreatic tail involvement in one patient. CT scan was used to diagnose one tumor located in the body of the pancreas. Mean tumor size was 8.0 cm, Surgical treatment consisted of two open pancreaticoduodenectomies, one laparoscopic pancreaticoduodenectomy, one laparoscopic subtotal pancreatectomy and one laparoscopic distal pancreatectomy. Surgical pathology revealed no evidence of vascular invasion in any of the tumors and an Ro resection complete resection with no microscopic residual tumor was obtained in all patient. No patients had involved lymph nodes with a mean of 16 lymph nodes inspected. No complications from any pancreatic resection were observed. Conclusion: Solid pseudopapillary tumors of the pancreas are a rare but treatable pancreatic tumor. Complete surgical excision is the treatment of choice and can be achieved through an open or minimal access technique.