Abstract

Surgical Approach for Solid Pseudopapillary Neoplasm of Pancreas Single - Centre Experience

Introduction Solid pseudopapillary neoplasm is a rare pancreatic tumor which arises from exocrine type cells and has specific progesterone receptors. It was described by American pathologist Virginia Kneeland Frantz in 1959. Solid pseudopapillary neoplasms compose less than 1% of exocrine tumors of the pancreas. At this time there are only 3725 cases published in the world literature. Material and methods retrospective study of treatment results 37 patients with pancreatic solid pseudopapillary neoplasms was performed. All of them were operated in №1 abdominal department A.V. Vishnevsky Institute of surgery, Moscow, Russia for the period 2007 - 2017 years. Data presented as median (Me) with interquartile range 25% and 75%. Results majority of patients were females - 34 (92%), there were only three males. Average age was 34 (25; 42) years. In 17 (46%) cases there were pancreatic head tumor, 8 (22%) patients had an SPN in the body and 12 (32%) in the tail of the pancreas. Mean tumor diameter composed 42 (26; 73) mm. pancreaticoduodenectomy was performed in 14 (38%) cases, distal pancreatectomy in 16 (43%), in 7 (20%) cases organ - preserving surgeries were performed. There were 7 cases (19%) of clinically relevant postoperative pancreatic fistula. Postpancreatecomy hemorrhage type C has occurred in three cases, all of them were stopped by endovascular procedure. Mortality rate was 1 (2.7%) in case of female with severe postoperative pancreatitis with respiratory distress - syndrome. Conclusion surgical procedure has a great importance and primary relevance in treatment of solid pseudopapillary neoplasm of the pancreas, even in metastatic cases. Benign solid pseudopapillary neoplasms have to be operated using minimal invasive technology and with organ preservation. Immunohystochemical specimen examination has to be performed in all cases. Investigation of epidemiology and occurrence of this tumor requires collaboration involving the entire scientific world.


Author(s):

Andrey Germanovich Kriger, Ayrat Radikovich Kaldarov, David Semyonovich Gorin, Stanislav Valer’evich Berelavichus



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