BACKGROUND Solid pseudopapillary neoplasms(SPN)of the pancreas represents approximately 2%of non-endocrine tumors of the pancreas.It is described in the literature as a rare and predominant tumor in young women.AIM To...BACKGROUND Solid pseudopapillary neoplasms(SPN)of the pancreas represents approximately 2%of non-endocrine tumors of the pancreas.It is described in the literature as a rare and predominant tumor in young women.AIM To report a case series with SPN and analyzing clinical,surgical,anatomopathological characteristics,as well as the prognosis and review of literature.METHODS Retrospective analysis of patients undergoing surgery,with histological diagnosis of SPN between 1998 and 2018,using standardized and prospectively completed forms,performed at the Surgery Service of the Upper Digestive System at Hospital São Rafael/Rede D’Or in Salvador-BA.Review of literature through a database search in MEDLINE/PubMed of retrospective articles.RESULTS Fourteen female patients with the average age of 31.6 years(range min-max)were selected.Twelve patients(85.7%)were asymptomatic,being an incidental diagnosis or due to screening for other reasons.One patient had abdominal pain due to gastric compression and another patient had jaundice.The 14 patients were staged with computerized tomography or magnetic resonance imaging.None had evidence of metastasis.In 8 patients(57.1%),the tumor was in the tail and body.The average size was 6.7 cm(range min-18).The type of surgery was according to the anatomical location of the tumor.There was no lymph node involvement.In two cases,vascular resection with the use of a prosthesis was required for reconstruction.The surgical margins were free.In all cases,postoperative immunohistochemistry confirmed that it was a solid pseudo-papillary neoplasia of the pancreas.There has been no disease recurrence in any case so far.CONCLUSION The tumors had a benign,indolent and histopathological behavior compatible with the literature.Curative surgery is recommended in all cases.展开更多
目的探讨胰腺实性假乳头状瘤(solid-pseudo-pap illary tumor of pancreas,SPT)的临床病理学特点及其生物学行为。方法对6例SPT临床及病理资料进行回顾性复习,光镜观察其形态学特征,并采用免疫组化S-P法检测肿瘤细胞α-AT等9种抗体的表...目的探讨胰腺实性假乳头状瘤(solid-pseudo-pap illary tumor of pancreas,SPT)的临床病理学特点及其生物学行为。方法对6例SPT临床及病理资料进行回顾性复习,光镜观察其形态学特征,并采用免疫组化S-P法检测肿瘤细胞α-AT等9种抗体的表达,并对其中1例做AB/PAS染色。结果6例SPT中5例为女性、1例为男性,平均年龄34岁,瘤体平均直径9.3cm;光镜下瘤细胞圆形,大小较一致,无明显异型性,排列成实性片状区和假乳头状结构,假乳头轴心黏液变性,囊性区常见出血、坏死;其中1例除上述特征外还出现了大量的印戒细胞样瘤细胞,这些瘤细胞AB/PAS染色阴性,CEA阴性,S-100蛋白阴性,随访至今已4年余,无复发及转移。2例浸润包膜及周围胰腺组织;6例中3例有随访的均健在且无复发及转移。免疫组化检测:6例V im阳性(6/6),4例α-AT阳性(4/6),3例Syn阳性(3/6),1例CK弱阳性(1/6)、PR阳性(1/6),ER阴性(0/6),EMA阴性(0/6),CEA阴性(0/6),S-100蛋白阴性(0/6)。结论SPT好发于年轻女性;组织形态学特征为瘤细胞大小一致,排列成实性片状区与独特的假乳头状结构,偶见瘤细胞呈印戒细胞样,间质可黏液变性;该肿瘤生物学行为交界性或恶性潜能未定的肿瘤,即使出现包膜及周围胰腺浸润,预后亦较好。展开更多
文摘BACKGROUND Solid pseudopapillary neoplasms(SPN)of the pancreas represents approximately 2%of non-endocrine tumors of the pancreas.It is described in the literature as a rare and predominant tumor in young women.AIM To report a case series with SPN and analyzing clinical,surgical,anatomopathological characteristics,as well as the prognosis and review of literature.METHODS Retrospective analysis of patients undergoing surgery,with histological diagnosis of SPN between 1998 and 2018,using standardized and prospectively completed forms,performed at the Surgery Service of the Upper Digestive System at Hospital São Rafael/Rede D’Or in Salvador-BA.Review of literature through a database search in MEDLINE/PubMed of retrospective articles.RESULTS Fourteen female patients with the average age of 31.6 years(range min-max)were selected.Twelve patients(85.7%)were asymptomatic,being an incidental diagnosis or due to screening for other reasons.One patient had abdominal pain due to gastric compression and another patient had jaundice.The 14 patients were staged with computerized tomography or magnetic resonance imaging.None had evidence of metastasis.In 8 patients(57.1%),the tumor was in the tail and body.The average size was 6.7 cm(range min-18).The type of surgery was according to the anatomical location of the tumor.There was no lymph node involvement.In two cases,vascular resection with the use of a prosthesis was required for reconstruction.The surgical margins were free.In all cases,postoperative immunohistochemistry confirmed that it was a solid pseudo-papillary neoplasia of the pancreas.There has been no disease recurrence in any case so far.CONCLUSION The tumors had a benign,indolent and histopathological behavior compatible with the literature.Curative surgery is recommended in all cases.
