Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yan-Jiang Xi Rd., GuangZhou, China.
Can J Surg. 2011 Dec;54(6):368-74. doi: 10.1503/cjs.011810.
Our aim was to summarize our experience with the diagnosis and surgical treatment of solid pseudopapillary neoplasm (SPN) of the pancreas to provide a reference for the management of this rare condition.
We collected and analyzed retrospective data on the clinical presentation, laboratory investigations, radiologic imaging, pathology and operative details of patients with SPN of the pancreas diagnosed between February 2001 and December 2009.
In all, 23 of 24 patients were women, and the mean age of all patients was 31 years. The most common clinical presentation was vague abdominal pain. Abdominal imaging showed solid or solid cystic masses in the pancreas, mostly in the tail or head of the gland. All patients were treated surgically. There were no postoperative deaths. After follow-up ranging from 4 to 109 months (median 68 mo), 20 of 22 patients who underwent curative resection were alive with no evidence of disease recurrence. Of the 2 patients with R1 resections, 1 died 42 months after surgery, whereas the other underwent a second operation and was alive after 36 months' follow-up.
Solid pseudopapillary neoplasm of the pancreas is a relatively indolent tumour. The initial diagnosis of SPN of the pancreas is suggested by radiologic imaging findings but should be considered in the context of clinical and histopathologic characteristics. We advocate for complete surgical resection once SPN is diagnosed.
我们旨在总结胰腺实性假乳头状瘤(SPN)的诊断和手术治疗经验,为这种罕见疾病的治疗提供参考。
我们收集并分析了 2001 年 2 月至 2009 年 12 月期间诊断为胰腺 SPN 的患者的临床特征、实验室检查、影像学、病理和手术细节的回顾性资料。
24 例患者中,23 例为女性,所有患者的平均年龄为 31 岁。最常见的临床表现为腹部隐痛。腹部影像学显示胰腺内实性或囊实性肿块,多位于胰尾或胰头部。所有患者均行手术治疗。无术后死亡。随访 4 至 109 个月(中位随访时间 68 个月)后,22 例接受根治性切除术的患者中,20 例无疾病复发,存活。2 例 R1 切除患者中,1 例术后 42 个月死亡,另 1 例接受二次手术,随访 36 个月后存活。
胰腺实性假乳头状瘤是一种相对惰性的肿瘤。胰腺 SPN 的初步诊断是基于影像学表现,但应结合临床和组织病理学特征进行考虑。我们主张一旦诊断为 SPN,就应进行完全的手术切除。