Clinical Characteristics And Treatment Of Solid Pseudopapillary Tumor Of Pancreas

Background and Purpose: Solid-pseudopapillary tumor of pancreas(SPTP) is a rarelow-grade malignancy, which has different characteristics of clinical manifestations,diagnosis, treatment, and prognosis from other pancreatic tumors. This study is toexplore and discuss the clinical characteristics and treatment ofsolid—pseudopapi11ary tumor of pancreas. Methods: A retrospective analysis wasmade on66cases of SPTP admitted from January2007to January2011in ChinesePeople’s Liberation Army General Hospita1．We analyzed the clinical manifestations,diagnosis, treatment, and prognosis. Results:(1) A total of66patients enrolled inthe study, including57women and9men．The average age of these66cases was30.08with a median age of31years, ranged from12to71years old. We found2peak incidence were under20years and30-40years old. The clinical manifestationswas non-specific, which48.5%of the patients were found by physical examinationand47.0%of the patients showed abdominal pain or discomfort. Imagingexamination could be initial diagnosed, but prone to misdiagnosis. It was non-specificfor liver function and serum tumor markers.(2) Pathology examination could bediagnosed. Typical SPTP includes solid area, pseudopapillary area and mixing area.Solid areas tumor cells were nests patchy distribution, which the cell was the samesize and rare mitotic. Pseudopapillary area constituted of consistent structure roundor oval tumor cells arrayed around fibrovascular axis, accompanying withhemorrhage, necrosis, cystic degeneration. Immunohistochemistry showed positive ofSyn, CD10, CD56, Vimentin, al-AT, NSE, ACT, AE1/AE3.(3) Surgical excisionwas primary therapy for SPTP, which based on the location of the tumor andviolation of organs. The tumors of16（24.2%）cases were located in the pancreatichead，13（24.2%）tumors were in the neck of pancreas and37（56.1%） tumors werein the body and tail of pancreas．All patients were performed operation, includingpancreaticoduodenectomy in8cases, simple resection of tumor in17cases, resection of tumors and pancreaticojejunostomy in10cases, distal pancreatectomy in21cases, distal pancreatectomy with spleen resection in8cases, and only abdominalexploration in2case.(4) SPTP results to good prognosis. We followed up all patientsand found64patients without recurrence or metastasis,1patient did not undergosurgical resection due to the death of tumor progression, and1patient surgicalresection again with liver metastases. Conclusion:1, Solid-pseudopapillary tumor ofpancreas was one of rare pancreatic neoplasm with low malignant potential，affectingprimarily young women;2, No characteristic in clinical manifestations, mainly asabdominal discomfort or by the physical findings;3, No specific characteristic inimaging examination, hepatic function and serum tumor markers;4, Pathologicaldiagnosis could be confirmed，which the pathological features was solid area,pseudopapillary area and mixing area, accompanying with hemorrhage, necrosis,cystic degeneration;5, Surgical excision was primary therapy for SPTP, which basedon the location of the tumor and violation of organs;6, The prognosis is good.