Bochis Ovidiu Vasile, Bota Madalina, Mihut Emilia, Buiga Rares, Hazbei Dan Samoila, Irimie Alexandru
Department of Medical Oncology, "Prof. Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.
Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2017;90(2):171-178. doi: 10.15386/cjmed-672. Epub 2017 Apr 25.
Solid pseudopapillary tumor (SPT) of the pancreas is a rare pathological condition, representing less than 3% of all exocrine pancreatic tumors. SPT usually occurs in young females, without notable symptoms, with a low malignant potential and excellent prognosis.
We conducted a retrospective study during the period January 2005 - January 2015. SPT patients admitted in our institution were reviewed by describing demographic data, clinico-pathologic and radiological features, therapeutic management and prognosis records.
Thirteen patients with SPT were identified (10 females), with a median age of 30 years. The main clinical presentation was abdominal pain (92.3%). The tumor was mostly located in the body or tail of the pancreas (77%), and the mean size was 8.2 cm. Regarding the surgical approach there were 5 distal pancreatectomies with splenectomy, 3 body and tail pancreatectomies, 2 body and tail pancreatectomies with splenectomy, 2 pancreato-duodenectomy, 1 partial enucleation and of all only 2 partial resections. Postoperative hematoxylin- eosin staining and immunohistochemistry confirmed the diagnosis in all cases. None of the patients had lymph nodes metastases. Only one local invasion. There was one case of death due to postoperative complications. Four cases followed adjuvant systemic chemotherapy. The mean follow-up was 18 months, without evidence of recurrence during this period.
SPT should always be considered in the differential diagnosis in young women with a pancreatic tumor. Complete surgical excision is the treatment of choice, and is usually curative. The decision to administer systemic therapy must be individualized. Malignant behavior and late recurrences mandates long-term follow-up for patients with SPT.
胰腺实性假乳头状瘤（SPT）是一种罕见的病理状况，占所有胰腺外分泌肿瘤的比例不到3%。SPT通常发生于年轻女性，症状不明显，恶性潜能低，预后良好。
我们在2005年1月至2015年1月期间进行了一项回顾性研究。对我院收治的SPT患者进行回顾，描述其人口统计学数据、临床病理和放射学特征、治疗管理及预后记录。
共确定13例SPT患者（10例女性），中位年龄30岁。主要临床表现为腹痛（92.3%）。肿瘤大多位于胰腺体部或尾部（77%），平均大小为8.2厘米。手术方式包括5例远端胰腺切除术加脾切除术、3例胰体尾切除术、2例胰体尾切除术加脾切除术、2例胰十二指肠切除术、1例部分摘除术，所有病例中仅2例为部分切除术。术后苏木精-伊红染色及免疫组化在所有病例中均确诊。所有患者均无淋巴结转移。仅1例有局部侵犯。有1例因术后并发症死亡。4例接受辅助全身化疗。平均随访18个月，在此期间无复发迹象。
对于患有胰腺肿瘤的年轻女性，鉴别诊断时应始终考虑SPT。完整的手术切除是首选治疗方法，通常可治愈。给予全身治疗的决定必须个体化。SPT患者的恶性行为和晚期复发需要长期随访。
