Premium
Preoperative diagnosis and surgical management for solid pseudopapillary neoplasm of the pancreas
Author(s) -
Hosokawa Isamu,
Shimizu Hiroaki,
Ohtsuka Masayuki,
Kato Atsushi,
Yoshitomi Hideyuki,
Furukawa Katsunori,
Takayashiki Tsukasa,
Ishihara Takeshi,
Yokosuka Osamu,
Miyazaki Masaru
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.96
Subject(s) - medicine , pancreaticoduodenectomy , endoscopic ultrasound , pancreas , radiology , fine needle aspiration , surgery , retrospective cohort study , biopsy
Background Preoperative diagnosis of solid pseudopapillary neoplasm of the pancreas ( SPN ) remains difficult and optimal surgical management for SPN has yet to be fully defined. Methods Retrospective analysis was undertaken of all 10 patients (six women, four men) who underwent surgery for SPN between 2001 and 2013. Results Mean age was 26 years (range, 16–33 years) for women, and 50 years (range, 35–76 years) for men. Although large SPN showed typical imaging findings, small SPN (≤3.0 cm) appears as almost entirely solid tumors. Endoscopic ultrasound‐guided fine‐needle aspiration ( EUS‐FNA ) was performed in six patients with atypical findings of SPN for differentiation from other pancreatic neoplasms. Definitive preoperative cytological diagnosis was achieved in all patients who underwent EUS‐FNA . All 10 patients underwent surgical exploration. One patient with portal vein invasion and multiple lung metastases underwent pancreaticoduodenectomy combined with portal vein resection and reconstruction, followed by two pulmonary resections. This patient remains alive as of 34 months after the initial operation. Conclusions Endoscopic ultrasound‐guided fine‐needle aspiration is useful for definitive preoperative diagnosis of SPN . As long‐term survival after surgical resection can be achieved even in patients with locally advanced and metastatic SPN , aggressive surgical resection should be performed.