Zhan Hanxiang, Cheng Yugang, Wang Lei, Su Peng, Zhong Ning, Zhang Zongli, Zhi Xuting, Hu Sanyuan
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
Department of Pathology, Qilu Hospital, Shandong University, Jinan, China.
J Laparoendosc Adv Surg Tech A. 2019 May;29(5):600-607. doi: 10.1089/lap.2018.0704. Epub 2019 Feb 11.
Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare pancreatic tumors. This study summarizes the clinicopathological characteristics and treatment outcomes of SPN patients through a 10-year single-center case series. Medical records of patients diagnosed with SPNs and who underwent surgery between August 2007 and July 2017 at Qilu Hospital, Shandong University, were retrospectively analyzed. This study included 91 patients: 13 males/78 females, mean age 28.8 ± 11.5 years. Among the cases, 38.5% were incidentally confirmed without specific symptoms, while the others displayed various abdominal symptoms. All patients had single pancreatic lesions, and 1 patient presented with liver metastasis. Abdominal enhanced computed tomography, magnetic resonance imaging, and endoscopic ultrasound were the diagnostic imaging techniques used to identify SPNs. All patients had successful surgical removal of their tumors; 28 patients underwent laparoscopy. During the 2-121-month follow-up period, 1 patient died of lung metastasis and multiple organ failure at 35 months postoperatively, but no other tumor recurrence or metastasis was found. SPN usually occurs in the young female population and presents with various clinical characteristics. Mixed solid-cystic masses with calcification or hemorrhage are typical morphological tumor features. Minimally invasive organ-/function-preserving operations are advocated for benign cases, while aggressive radical resection should be performed in patients with local invasion or distant metastasis.
胰腺实性假乳头状肿瘤(SPN)是一种罕见的胰腺肿瘤。本研究通过一项为期10年的单中心病例系列总结了SPN患者的临床病理特征及治疗结果。对2007年8月至2017年7月期间在山东大学齐鲁医院诊断为SPN并接受手术治疗的患者的病历进行回顾性分析。本研究纳入91例患者:男性13例/女性78例,平均年龄28.8±11.5岁。其中,38.5%的病例为偶然确诊,无特异性症状,其余患者表现出各种腹部症状。所有患者均有单一胰腺病变,1例患者出现肝转移。腹部增强计算机断层扫描、磁共振成像和内镜超声是用于识别SPN的诊断成像技术。所有患者均成功手术切除肿瘤;28例患者接受了腹腔镜手术。在2至121个月的随访期内,1例患者术后35个月死于肺转移和多器官功能衰竭,但未发现其他肿瘤复发或转移。SPN通常发生于年轻女性群体,具有各种临床特征。伴有钙化或出血的混合实性囊性肿块是典型的肿瘤形态学特征。对于良性病例,提倡进行微创器官/功能保留手术,而对于有局部侵犯或远处转移的患者应进行积极的根治性切除。