SOLID PSEUDOPAPILLARY TUMOR OF THE PANCREAS: ANALYSIS OF CLINIOPATHOLOGICAL FEATURES AND SURGICAL OUTCOMES

Document Type : Original Article

Authors

1 Department of Surgery, Faculty of Medicine, Alexandria University, Egypt

2 Departement of Pathology, Faculty of Medicine, Alexandria University, Egypt

Abstract

Background: Solid-pseudopapillary tumor (SPT) of the pancreas is an uncommon pancreatic neoplasm with a 
low-grade malignancy that occurs mainly in young women. This study was undertaken to analyze the 
clinicopathological characteristics of the disease and to evaluate the outcome of surgical intervention in a 
tertiary referral cancer centre. 
Methods: A prospectively maintained database of the characteristics of 14 patients (13 females and 1 male), 
with a mean age of 21.6 years (range 17-34 years) who underwent surgical resection in our institution with a 
definitive histological and immunohistochemical diagnosis of SPT between 2002 and 2012 was developed and 
analyzed. Results:
5 cases (37%) presented with dull aching pain, palpable mass in 3 cases (21%), with incidental detection in 3 
cases (21%). The tumor was located in the body/tail in 12 cases and in the head in 2 patients. Mean tumor 
diameter was 10.7cm (range 5-21). Tumors of the head were smaller (average 6.3 cm) but more symptomatic 
than those in the body-tail (average 13 cm). None of the patients had metastases at presentation. 2 cases 
underwent pancreaticoduodenectomy, 2 enucleations, while 10 patients had left pancreatectomy. All cases 
were positive for nuclear β-catenin, and negative for membranous E-cadherin immunoreactivity. Overall 
morbidity rate was 22% with no mortality. At a median follow-up of 62 months (range 15–110), all patients 
are alive without evidence of local recurrence, metastasis, but one case of diabetes developed.
Conclusion: SPT is an indolent neoplasm with characteristic macroscopic, microscopic, and 
immunohistochemical features. The low grade biological aggressiveness makes surgical resection possible 
despite its large size and patients can survive a long period after the operation.

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