Solid pseudopapillary neoplasms of the pancreas: An 18-year experience at a single Japanese Institution

Purpose: This study investigated the clinicopathological features and surgical management of solid pseudopapillary neoplasms at a single institution in Japan. Methods: Seventeen patients (the largest series in Japan) those underwent surgery for pathologically confirmed solid pseudopapillary neoplasms were retrospectively reviewed. Results: Sixteen patients were women and their mean age was 34.1years. Most patients were asymptomatic (n=11), and the average tumor diameter was 51.8mm. The most common imaging characteristic was tumors of solid and cystic type (n=10), which were most commonly located in the pancreatic body (n=7). All patients underwent surgical exploration, i.e., distal pancreatectomies in 7 patients (laparoscopically performed in 2); middle pancreatectomies, 4; pancreaticoduodenectomies, 4; enucleation, 1; and liver resection, 1. No surgical mortalities occurred, and postsurgical complications occurred in 9 patients. Four patients had malignant tumors. One patient with liver metastases experienced recurrence, which was well controlled by paclitaxel. The remaining patients were disease free at a median follow-up of 51months. Conclusions: Solid pseudopapillary neoplasms can be treated by complete tumor resection with limited resection or a minimally invasive approach when applicable. The combination of surgical resection and chemotherapy may therefore prolong survival, even in malignant cases.