Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University College of Medicine, No. 88 Jiefang Road, Zhejiang, People's Republic of China.
Surg Today. 2013 Feb;43(2):148-54. doi: 10.1007/s00595-012-0260-3. Epub 2012 Jul 24.
Solid-pseudopapillary neoplasms (SPNs) are rare pancreatic tumors, with a low potential for malignancy. The clinical and pathological features of 33 SPNs were reviewed.
This study conducted a retrospective analysis of 33 patients who underwent surgery for a pathologically confirmed SPN from 2000 to 2011.
Thirty of the 33 patients (91 %) were female, and the median age at diagnosis was 29.2 years (range 12-59). The most common symptom was abdominal discomfort with dull pain (58 %). Others included asymptomatic lesions that were only detected incidentally during imaging (21 %), a palpable abdominal mass (15 %) and indigestion (6 %). All 33 patients underwent surgery with a curative intent and 3 (9 %) underwent laparoscopic surgery. The mean diameter of the tumors was 4.9 cm (range 2-15 cm), and they occurred in the head (9, 27 %), neck (5, 15 %), body or tail (19, 58 %) of the pancreas. One patient had lymph node metastases, one patient had portal venous invasion and 8 patients had perineural invasion. The patient follow-up ranged from 4 to 118 months, and 32 patients were alive and well without recurrence. One patient relapsed 10 months after distal pancreatectomy with splenectomy and underwent a second surgery via laparotomy. Unfortunately, the patient died of multiple organ failure 12 days after the second surgery.
SPNs are rare neoplasms with malignant potential but excellent prognosis. Adequate surgical resection, including laparoscopic surgery, may therefore be performed safely and is associated with a long-term survival, even in invasive cases.
实性假乳头状肿瘤（SPN）是一种罕见的胰腺肿瘤，恶性潜能较低。本研究回顾性分析了 2000 年至 2011 年间经手术治疗并经病理证实的 33 例 SPN 患者的临床和病理特征。
本研究回顾性分析了 2000 年至 2011 年间经手术治疗并经病理证实的 33 例 SPN 患者的临床和病理特征。
33 例患者中 30 例（91%）为女性，诊断时的中位年龄为 29.2 岁（范围 12-59）。最常见的症状是腹部不适伴隐痛（58%）。其他包括无症状病变，仅在影像学检查中偶然发现（21%）、可触及的腹部肿块（15%）和消化不良（6%）。所有 33 例患者均行根治性手术治疗，其中 3 例（9%）行腹腔镜手术。肿瘤的平均直径为 4.9cm（范围 2-15cm），位于胰头部（9 例，27%）、胰颈（5 例，15%）、胰体尾部（19 例，58%）。1 例患者发生淋巴结转移，1 例患者发生门静脉侵犯，8 例患者发生神经周围侵犯。患者随访时间为 4-118 个月，32 例患者存活且无复发。1 例患者在胰体尾切除加脾切除后 10 个月复发，再次行剖腹探查术。不幸的是，该患者在第二次手术后 12 天死于多器官功能衰竭。
SPN 是一种罕见的具有恶性潜能但预后良好的肿瘤。因此，充分的手术切除，包括腹腔镜手术，是安全的，即使在侵袭性病例中，也可获得长期生存。
