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solid-pseudopapillary tumor of the Pancreas:One Case Report and Literatures Review

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Chinese Journal of Clinical Oncology 2009年第2期6卷 155-156页

作者： Shifu Hu Naiqiang Cui Erpeng Zhao Surgery Department Tianjin Xiqing HospitalTianjin 300380 China National Medicial Center of Bilio-Pancreatic Diseases Nankai Hospital Tianjin 300100China

Introductionsolid-pseudopapillary tumor(SPT)is a very rare primary neoplasmof the *** first described it in *** is usually seen inyoung *** spite of possible histological findings of malignan-cy,SPPT typically shows a benign clinical course and a low malig-nant *** pathogenesis of these tumors is still *** has been suggested that it might originate from ductal and acinarpancreatic cells,endocrine cells or pluripotential stem cells.

关键词： solid-pseudopapillary tumor pancreas surgery.

Aggressive behaviour of solid-pseudopapillary tumor of the pancreas in adults:A case report and review of the literature

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World Journal of Gastroenterology 2008年第6期14卷 960-965页

作者： Cosimo Sperti Mattia Berselli Claudio Pasquali Davide Pastorelli Sergio Pedrazzoli Department of Medical and Surgical Sciences Clinica Chirurgica Ⅳ University of Padua Padua 35128 Italy Department of Oncology Istituto Oncologico Veneto Padua Italy

solid-pseudopapillary tumor (SPT) is a rare neoplasm of the pancreas that usually occurs in young females. It is generally considered a low-grade malignant tumor that can remain asymptomatic for several years. The occurrence of infiltrating varieties of SPT is around 10%-15%. Between 1986 and 2006, 282 cystic tumors of the pancreas were observed. Among them a SPT was diagnosed in 8 patients (2.8%) with only one infiltrating variety. This was diagnosed in a 49-year-old female 13 years after the sonographic evidence of a small pancreatic cystic lesion interpreted as a pseudocyst. The tumor invaded a long segment of the portal- mesenteric vein confluence, and was removed with a total pancreatectomy, resection of the portal vein and reconstruction with the internal jugular vein. Histological examination confirmed the R-0 resection of the primary SPT, although a vascular invasion was demonstrated. The postoperative course was uneventful, but 32 mo after surgery the patient experienced diffuse liver metastases. Chemotherapy with different drugs was started. The patient is alive and symptom-free, with stable disease, 75 mo after surgery. Twenty-five patients with invasion of the portal vein and/or of mesenteric vessels were retrieved from the literature, 16 recent patients with tumor relapse after potentially curative resection were also retrieved. The best treatment remains a radical resection whenever possible, even in locally advanced or metastatic disease. The role of chemotherapy, and/or radiotherapy, is still to be defined.

关键词： solid-pseudopapillary tumor Pancreatectomy Vascular resection Liver metastases Follow-up

Clinical analysis of solid-pseudopapillary tumor of the pancreas:report of 15 cases

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Hepatobiliary & Pancreatic Diseases International 2008年第2期7卷 196-200页

作者： Chen, Shao-Qin Zou, Sheng-Quan Dai, Qi-Bao Li, Hong Huazhong Univ Sci & Technol Tongji Hosp Tongji Med Coll Dept Gen Surg Wuhan 430030 Peoples R China

BACKGROUND: solid-pseudopapillary tumor of the pancreas (SPTP) is an uncommon and enigmatic pancreatic neoplasm that occurs mainly in young women. Although more and more cases have been reported in recent years, misdiagnosis and incorrect treatment still frequently take place. This study was designed to stimulate consideration of this tumor. METHODS: We retrospectively reviewed the experience of diagnosis and treatment of 15 patients with SPTP and compared them with 516 patients with pancreatic cancer from January 1997 to March 2007. RESULTS: Most of the SPTP cases were asymptomatic except for one palpable mass. Almost all SPTPs demonstrated a solid structure with hypo- or isoattenuation, cystic structure with hypo-attenuation on precontrast CT scan, and enhancement of solid portions on post-contrast CT scan. By contrast, most cases of pancreatic carcinoma had multiple symptoms and abnormal blood results. The tumors showed hypo-attenuation on both precontrast and post-contrast CT scan, and only a few showed iso-attenuation on post-contrast CT scan. All cases of SPTP in our group were cured by surgical resection, while only 16.86% of patients with pancreatic carcinoma could undergo a radical resection. CONCLUSIONS: Clinical features and CT scans were helpful to differentiate SPTP from pancreatic carcinoma. Radical surgical resection was the most effective and safe method for the treatment of SPTP.

关键词： pancreatic neoplasm solid-pseudopapillary tumor diagnosis treatment

Diagnosis and treatment of solid-pseudopapillary tumor of the pancreas

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Hepatobiliary & Pancreatic Diseases International 2006年第3期5卷 454-458页

作者： Hao Zhang, Ting-Bo Liang, Wei-Lin Wang, Yan Shen, Guo-Ping Ren and Shu-Sen Zheng Department of Hepatobiliary Surgery , and Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China Department of Hepatobiliary Surgery First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China.

BACKGROUND: solid-pseudopapillary tumor (SPT) of the pancreas is a rare exocrine pancreatic tumor. Despite the increasing recognition of the tumor in recent years, its pathogenesis and apparent therapeutic algorithm remain unclear. This study was designed to define the clinical, imaging, and pathologic features and to improve the diagnosis and treatment of this rare disease. METHOD: The clinical, imaging, and pathologic findings of 9 SPT patients managed in our hospital between 2001 and 2005 were retrospectively analyzed, and related literatures were reviewed. RESULTS: In the 9 patients aged from 14 to 68 years, 8 were female and 1 male. The mean age of these patients at diagnosis was 30 years. Initially, 8 patients complained of vague abdominal pain and one patient had pancreatic mass detected incidentally by abdominal CT. The levels of blood and urine amylase and tumor markers were all within the normal range. B-US, CT and MRI demonstrated that tumors were well encapsulated and contained some degree of internal hemorrhage or cystic degeneration. The mean transverse diameter of these tumors was 5.4 cm (range, 2-10.5 cm). The tumors were located at the head (2 patients), body (2), body and tail junction (4), and tail (1) of the pancreas. Surgical procedures included pancreaticoduodenectomy, distal pancreatectomy, distal pancreatectomy with splenectomy, and enucleation. Histological examination showed solidified cystic areas and papillary protrusions. Two malignant tumors demonstrated retroperitoneal metastases and vascular invasion. Follow-up for 2.5 years on average showed that one patient died of tumor recurrence at 10 months and the rest were alive. CONCLUSIONS: SPT exhibits unique clinical and pathologic features and is readily diagnosed by its characteristic imaging and histological appearance. Surgical resection of the primary tumor and metastases is the treatment of choice.

关键词： solid-pseudopapillary tumor pancreas diagnosis treatment

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas:report of 9 cases

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Journal of Nanjing Medical University 2007年第6期21卷 398-401页

作者： Shaoqin Chen Shengquan Zou Qibao Dai Peisheng Huang Weihua Cai Hong Li Department of Oncology First Affiliated Hospital of Fujian Medical University Fuzhou 350005 Fujian Province China Department of General Surgery Affiliated Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology Wuhan 430030 Hubei Province China Department of Pathology First Affiliated Hospital of Fujian Medical University Fuzhou 350005 Fujian Province China

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.

关键词： pancreatic neoplasm solid-pseudopapillary tumor pancreas

Plummer-Vinson syndrome associated with solidpseudopapillary tumor of the pancreas

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Chinese Medical Journal 2007年第17期120卷 1553-1555页

作者： Fahmi Yousef Khan A Haleem EL-Hiday Nader A Morad Department of Medicine Hamad General HospitalDoha 3050Qatar

Plummer-Vinson syndrome （PVS）, also known as Paterson-Kelly syndrome or sideropenic dysphagia1 is characterized by dysphagia, iron deficiency anemia and esophageal webs. This syndrome is known to be associated with an increased risk of hypopharyngeal and/or cervical esophageal cancer. Three to 15 percent of the patients with PVS, mostly women between 15 and 50 years of age, have been reported to develop esophageal or pharyngeal cancer. There is a decreasing trend in the overall incidence of hypopharyngeal cancer in women, probably due to the diminished prevalence of PVS. There are few reports of gastric cancer in association with PVS.2

关键词： Plummer-Vinson syndrome pancreas solid-pseudopapillary tumor