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Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India

INTRODUCTION: Solid pseudopapillary tumor (SPT) of the pancreas is rare, accounting for 0.13–2.7% of all pancreatic tumors. It is unique, has low malignant potential and predominantly affects young women. Radiological and pathological studies have revealed that the tumor is quite different from othe...

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Autores principales: Bhutani, Namita, Kajal, Pradeep, Singla, Sham, Sangwan, Vijender
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5581377/
https://www.ncbi.nlm.nih.gov/pubmed/28858740
http://dx.doi.org/10.1016/j.ijscr.2017.07.064
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author Bhutani, Namita
Kajal, Pradeep
Singla, Sham
Sangwan, Vijender
author_facet Bhutani, Namita
Kajal, Pradeep
Singla, Sham
Sangwan, Vijender
author_sort Bhutani, Namita
collection PubMed
description INTRODUCTION: Solid pseudopapillary tumor (SPT) of the pancreas is rare, accounting for 0.13–2.7% of all pancreatic tumors. It is unique, has low malignant potential and predominantly affects young women. Radiological and pathological studies have revealed that the tumor is quite different from other pancreatic tumors. But the cell origin of SPT and tumorigenesis are still enigmatic. Abdominal mass is the most common presenting symptom. Due to the paucity of the number of cases, the natural history of the disease is not fully understood. This study was undertaken to examine the clinico-pathological characteristics of the disease and to evaluate the outcome of surgical intervention in a tertiary referral care centre. MATERIALS AND METHODS: A retrospective analysis of all patients diagnosed and treated for SPN in our hospital over a period of 10 years (2005–2015) was carried out. A database of the characteristics of these patients was developed. In all, 11 patients were identified. A CT scan of the abdomen was performed in all the patients and the findings revealed a mass in the pancreas. The investigations performed included routine blood investigations, chest X-ray, CA-19-9 level and either an ultrasound or a CT Scan of the abdomen. RESULTS: During the time period of 10 years, of 349 patients with pancreatic malignancy admitted to our department, only 11 were diagnosed as having SPN (3.15%). Ten patients were women (90%) and one patient was a man (10%). The patients had a median age of 27.6 years (range 17–41). The most common symptoms were abdominal pain and dullness. Eight patients (72.7%) presented with abdominal pain or abdominal dullness and three patient (27%) were asymptomatic. All the 11 patients were taken up for surgery. Three patients underwent distal pancreatectomy with splenectomy, three patients underwent the total mass excision and one patient underwent total pancreatic resection. Three required extended distal pancreatectomy with splenectomy. One underwent spleen-preserving distal pancreatectomy. CONCLUSION: SPT is rare, but treatable pancreatic tumor. While clinical signs and symptoms are relatively nonspecific, characteristic findings on imaging and histology separate these tumors from the more malignant pancreatic tumors. The prognosis is favorable even in the presence of distant metastasis. Although surgical resection is generally curative, a close follow-up is advised in order to diagnose a local recurrence or distant metastasis.
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spelling pubmed-55813772017-09-06 Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India Bhutani, Namita Kajal, Pradeep Singla, Sham Sangwan, Vijender Int J Surg Case Rep Article INTRODUCTION: Solid pseudopapillary tumor (SPT) of the pancreas is rare, accounting for 0.13–2.7% of all pancreatic tumors. It is unique, has low malignant potential and predominantly affects young women. Radiological and pathological studies have revealed that the tumor is quite different from other pancreatic tumors. But the cell origin of SPT and tumorigenesis are still enigmatic. Abdominal mass is the most common presenting symptom. Due to the paucity of the number of cases, the natural history of the disease is not fully understood. This study was undertaken to examine the clinico-pathological characteristics of the disease and to evaluate the outcome of surgical intervention in a tertiary referral care centre. MATERIALS AND METHODS: A retrospective analysis of all patients diagnosed and treated for SPN in our hospital over a period of 10 years (2005–2015) was carried out. A database of the characteristics of these patients was developed. In all, 11 patients were identified. A CT scan of the abdomen was performed in all the patients and the findings revealed a mass in the pancreas. The investigations performed included routine blood investigations, chest X-ray, CA-19-9 level and either an ultrasound or a CT Scan of the abdomen. RESULTS: During the time period of 10 years, of 349 patients with pancreatic malignancy admitted to our department, only 11 were diagnosed as having SPN (3.15%). Ten patients were women (90%) and one patient was a man (10%). The patients had a median age of 27.6 years (range 17–41). The most common symptoms were abdominal pain and dullness. Eight patients (72.7%) presented with abdominal pain or abdominal dullness and three patient (27%) were asymptomatic. All the 11 patients were taken up for surgery. Three patients underwent distal pancreatectomy with splenectomy, three patients underwent the total mass excision and one patient underwent total pancreatic resection. Three required extended distal pancreatectomy with splenectomy. One underwent spleen-preserving distal pancreatectomy. CONCLUSION: SPT is rare, but treatable pancreatic tumor. While clinical signs and symptoms are relatively nonspecific, characteristic findings on imaging and histology separate these tumors from the more malignant pancreatic tumors. The prognosis is favorable even in the presence of distant metastasis. Although surgical resection is generally curative, a close follow-up is advised in order to diagnose a local recurrence or distant metastasis. Elsevier 2017-08-24 /pmc/articles/PMC5581377/ /pubmed/28858740 http://dx.doi.org/10.1016/j.ijscr.2017.07.064 Text en © 2017 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Bhutani, Namita
Kajal, Pradeep
Singla, Sham
Sangwan, Vijender
Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India
title Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India
title_full Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India
title_fullStr Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India
title_full_unstemmed Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India
title_short Solid pseudopapillary tumor of the pancreas: Experience at a tertiary care centre of Northern India
title_sort solid pseudopapillary tumor of the pancreas: experience at a tertiary care centre of northern india
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5581377/
https://www.ncbi.nlm.nih.gov/pubmed/28858740
http://dx.doi.org/10.1016/j.ijscr.2017.07.064
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