Khoury Tawfik, Farraj Moaad, Sbeit Wisam, Lisotti Andrea, Napoléon Bertrand
Department of Gastroenterology, Galilee Medical Center, Nahariya, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 5290002, Israel.
Department of Surgery B, Galilee Medical Center, Nahariya, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 5290002, Israel.
Cancers (Basel). 2025 Jul 4;17(13):2240. doi: 10.3390/cancers17132240.
Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor with malignant potential. Its diagnosis has grown alongside increased use of abdominal imaging. SPN is suspected after classical findings in abdominal imaging studies; however, endoscopic ultrasound-guided (EUS) fine needle aspiration can support preoperative diagnosis. The treatment of choice is still surgical intervention, with an intent to reach curative resection. The prognosis is excellent. Recently, emerging data on EUS-guided radiofrequency ablation (RFA) suggest changing the choice of treatment for small SPN. We provide a comprehensive overview on pancreatic SPN with a focus on treatment, adverse events, recurrence rate, and outcomes. In addition, we provide a literature summary and pool data analysis. Overall, 70 papers including 6651 patients were identified. The mean SPN size was 5.8 cm, metastasis rate was 1.9%, and recurrence rate was 3%. Moreover, the mortality rate was low at 0.2%, although high postoperative adverse events were reported (32.4%). Small SPN (<2 cm) was present in 4.1% of the studies. Two studies reported EUS-RFA for small SPN <2 cm, without recurrence at a median follow-up of 18.5 months. SPN still necessitates surgical intervention given its malignant potential. However, EUS-RFA can represent a promising and safe therapeutic option for SPN < 2 cm.
实性假乳头状肿瘤（SPN）是一种具有恶性潜能的罕见胰腺肿瘤。随着腹部影像学检查的广泛应用，其诊断率有所提高。腹部影像学检查出现典型表现后可怀疑为SPN；然而，内镜超声引导下（EUS）细针穿刺抽吸可支持术前诊断。首选治疗方法仍是手术干预，目的是实现根治性切除。预后良好。最近，有关EUS引导下射频消融（RFA）的新数据表明，小SPN的治疗选择可能会发生变化。我们全面概述了胰腺SPN，重点关注治疗、不良事件、复发率和治疗结果。此外，我们还提供了文献综述和汇总数据分析。总体而言，共纳入70篇论文，涉及6651例患者。SPN的平均大小为5.8 cm，转移率为1.9%，复发率为3%。此外，死亡率较低，为0.2%，尽管术后不良事件发生率较高（32.4%）。4.1%的研究中存在小SPN（<2 cm）。两项研究报告了对小于２cm的小SPN进行EUS-RFA治疗，中位随访18.5个月时无复发。鉴于SPN具有恶性潜能，仍需要进行手术干预。然而，EUS-RFA对于<2 cm的SPN可能是一种有前景且安全的治疗选择。
