Diagnosis And Surgical Treatment Of 13 Cases Solid Pseudopapillary Tumor Of Pancreas

Objective: To explore the clinical manifestation, diagnosis, surgical treatment and prognosis of solid pseudopapillary tumors of pancreas and elevate its diagnosis accuracy and treatment efficacy.Methods: A retrospectively analysis was conducted in 13 patients with SPT who were treated by the second affiliated hospital of Dalian Medical University, from October 2002 to October 2010.Results: All the patients were female, with an average age of 22.8, from 11 to 32. The median size of the removal tumor was 6.05cm varying from 1.3 to 10.8cm, and all 13 cases were single solid tumor appearance. The clinical manifestations of solid pseudopapillary tumors of pancreas were varied. 7 patients (55.8%) saw doctor because of upper abdomen discomfort including 4 with painless abdominal mass, 1 with pain abdominal mass and 2 without abdominal mass. 3 patients (23%) were in hospital because of nausea or vomiting. 3 patients (23%) were detected by ultrasound in physical examinations without any clinical manifestation. All the patients were healthy before, without any abdominal trauma or pancreatic disease, no smoking and drinking history. All the 13 patients underwent biochemical,fasting blood glucose,CEA,CA19-9 and AFP assays, and the results were normal. Tumor were located at different parts of the pancreas, 3 at caput pancreatis, 2 at neck of pancreas, 6 at body of pancreas and 2 at tail of pancreas. All the 13 patients were treated by surgical methods, 8 of them underwent local tumor resection, 3 underwent segmental resection of the pancreas and 2 underwent pancreatic body and tail resection plus splenectomy. The cut surfaces were alternated by cystic and solid tissue, with hemorrhage and necrosis, the gray-brown necrotic tissue were seen in the cystic cavities. None of the patients underwent chemotherapy or radiotherapy after surgery. 1 patient got pancreatic fistula and intra-abdominal infections, resolved by drainage and better supportive therapies with reovery, the other patients were in good status after operation. All the patients were followed up 4 to 24 months and no one got recurrence, metastasis or death.Conclusions:1. The clinical manifestations of solid pseudopapillary tumors of pancreas were various without typical symptoms, more cases in young women and with low morbidity.2. It is difficult to define the qualitative of solid pseudopapillary tumors of pancreas clearly before surgery, medical imaging offer a guiding significance for the diagnosis of solid pseudopapillary tumors of pancreas and more attention should be given to the scenario when there are cystic and solid tumors with envelopes and clear boundaries,meanwhile, without endocrine dysfunction or expansion of bile duct and pancreatic duct. Physical examination is beneficial to earlier discovery of solid pseudopapillary tumors of pancreas.3. Surgical treatment is the only effective strategy for borderline tumor, which were located in different parts of pancreas. It is better to give individual surgical way to different patient.4. The tumors with entire envelope can be removed completely as the good biological characteristics of solid pseudopapillary tumors of pancreas. Most patients can get good prognosis with low recurrence and metastatic rate.