Flavio SilanoHospital São Rafael/Rede D'Or, Brazil
Title: Yield of surgery in solid pseudopapillary neoplasms of the pancreas: A case series and literature review
Background: Solid pseudopapillary neoplasms (SPN) of the pancreas represents approximately 2% of non-endocrine tumors of the pancreas. It is described in the literature as a rare and predominant tumor in young women.
Methods: To report a case series with SPN and analyzing clinical, surgical, anatomopatho- logical characteristics, as well as the prognosis and review of literature. Retrospective analysis of patients undergoing surgery, with histological diagnosis of SPN between 1998 and 2018, using standardized and prospectively completed forms, performed at the Surgery Service of the Upper Digestive System at Hospital Sa?o Rafael/Rede D’Or in Salvador - BA. Review of literature through a database search in MEDLINE/PubMed of retrospective articles.
Results: Fourteen female patients with an average age of 31.6 years (range min-max) were selected. Twelve patients (85.7%) were asymptomatic, being an incidental diagnosis or due to screening for other reasons. One patient had abdominal pain due to gastric compression and another patient had jaundice. The 14 patients were staged with computerized tomography or magnetic resonance imaging. None had evidence of metastasis. In 8 patients (57.1%), the tumor was in the tail and body. The average size was 6.7 cm (range min-18). The type of surgery was according to the anatomical location of the tumor. There was no lymph node involvement. In two cases, vascular resection with the use of a prosthesis was required for reconstruction. The surgical margins were free. In all cases, postoperative immunohistochemistry confirmed that it was a solid pseudo-papillary neoplasia of the pancreas. There has been no disease recurrence in any case so far.
Conclusion: The tumors had a benign, indolent and histopathological behavior compatible with the literature. Curative surgery is recommended in all cases
Flávio Silano, specialist in digestive system surgery, specialist in nutritional therapy, fellowship in gastric cancer surgery at the National Cancer Center - Tokyo - Japan, Fellowship in esophageal cancer surgery at the Memorial Sloan Kettering Cancer Center - New York - US. Reviewer of the World Journal of Clinical Case