AN ANALYSIS OF SOLID PSEUDOPAPILLARY NEOPLASMS OF PANCREAS - 10 YEARS EXPERIENCE IN A TERTIARY CENTRE.

Abstract

Background - Solid pseudopapillary neoplasm
(SPN) is a rare tumour with low
malignant potential comprising 0.13 to
2.7 of all pancreatic tumours. The aim of
this study was to analyse clinical and
pathologic characteristics and surgical
outcomes of SPNs. Methods - Clinical
data from 2001 to 2010 were retrospectively
analysed for SPN. Thirteen cases
of solid pseudo papillary tumours were
reported in our institute. Clinical and
pathological features, radiological findings,
surgical intervention, follow up details
were reviewed.Results - Total number
of SPN was thirteen. Twelve patients
were female (92 percent). Median age of
presentation was 23 years. Predominant
symptom was abdominal pain (69 percent).
Ten patients (77percent) presented
with solid cystic component.
Three were solid tumours. Preoperative
diagnostic possibility of SPNs was considered
in eight patients (61.5 percent)
on basis of clinical radiological
findings. Radiological features suggestive
of malignancy were seen in two. Two patients
were diagnosed as SPN by FNAC.
Eleven patients (84.6 percent) underwent
complete resection ( distal pancreatectomy
9 , central pancreatectomy 2 ) . One patient
underwent palliative resection. Another one
was inoperable and received palliative chemotherapy.
On follow up( 6 months to 10
years ), patients who underwent complete
resection did not develop recurrence. Patients
who underwent palliative chemotherapy,
died after twenty two months due to
advancement of the disease . Patient who
underwent palliative resection was on regular
follow up. Conclusion - Preoperative diagnosis
of SPN is crucial in order to propose
the proper management . Offering
palliative resection gives better results and
associated with long term survival even in
advanced SPNs.