Harada Atsushi, Kurobe Masashi, Miyaguni Kazuaki, Sugihara Tetsuro, Kaji Sayuri, Kanamori Daisuke, Uchida Goki, Baba Yuji, Hiramatsu Tomomasa, Ohashi Shinsuke
Pediatric Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, JPN.
Pediatric Surgery, The Jikei University School of Medicine, Tokyo, JPN.
Cureus. 2024 Oct 1;16(10):e70655. doi: 10.7759/cureus.70655. eCollection 2024 Oct.
Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors with low malignant potential that usually occur in young girls and women. This study investigated the treatment experiences and outcomes after surgery for pediatric SPNs in our institutions as pediatric case series of solid SPNs are few, and long-term follow-up is also limited.
We retrospectively reviewed the outcomes of nine patients diagnosed with SPNs who underwent surgery in our three hospitals (The Jikei University Hospital, The Jikei University Kashiwa Hospital, and Kawaguchi Municipal Medical Center) between 2001 and 2023.
All nine patients who underwent surgery were girls. Their ages ranged from 8 to 15 years (median: 10 years). The location of the tumor was at the pancreatic head, body, and tail in five, one, and three patients, respectively. Enucleation, pancreaticoduodenectomy, and laparoscopic distal pancreatectomy (LDP) were performed in four, two, and three patients, respectively. Regarding postoperative complications, a pancreatic fistula was detected in six patients, with three and three patients having grades A and B fistulas, respectively; two patients required percutaneous drainage, and one patient required endoscopic ultrasonography (EUS)-guided transgastric drainage. The follow-up period ranged from six to 261 months (median: 97 months). At the final follow-up, all nine patients were alive without recurrence.
SPNs of the pancreas are incidentally diagnosed by diagnostic workups following trauma in children more frequently compared to adults. Additionally, the tumor resection by minimally invasive approaches, such as enucleation, or laparoscopic procedures results in a good prognosis in some cases.
胰腺实性假乳头状瘤（SPN）是一种罕见肿瘤，恶性潜能低，通常发生于年轻女孩和女性。由于小儿实性SPN的病例系列较少，长期随访也有限，本研究调查了我们机构中接受手术治疗的小儿SPN的治疗经验和结果。
我们回顾性分析了2001年至2023年期间在我们三家医院（东京慈惠会医科大学医院、东京慈惠会医科大学柏医院和川口市立医疗中心）接受手术的9例诊断为SPN的患者的结果。
所有9例接受手术的患者均为女孩。年龄范围为8至15岁（中位数：10岁）。肿瘤位置分别位于胰头、胰体和胰尾的患者有五例、一例和三例。分别有4例、2例和3例患者接受了肿瘤剜除术、胰十二指肠切除术和腹腔镜远端胰腺切除术（LDP）。关于术后并发症，6例患者检测到胰瘘，其中3例和3例患者分别为A级和B级瘘；2例患者需要经皮引流，1例患者需要内镜超声（EUS）引导下经胃引流。随访期为6至261个月（中位数：97个月）。在最后一次随访时，所有9例患者均存活且无复发。
与成人相比，儿童胰腺SPN更常因创伤后的诊断检查而被偶然诊断。此外，通过微创方法（如剜除术）或腹腔镜手术进行肿瘤切除在某些情况下可带来良好的预后。
