Sathish Obalanarasimhaiah1, Nagesh Nayakarahalli Swamygowda2, Balakrishna Nanjundappa Setty3, Kasturi Thirumangalam Subramani4
BACKGROUND
Solid pseudopapillary neoplasm (SPN) of pancreas is a rare epithelial tumour of
low malignant potential. SPN accounts for less than 1 to 2 % of exocrine pancreatic
tumours. It mainly affects women between the second and third decade of life,
and its management is not well defined. The aim of this study was to report
clinicopathological characteristics of SPN and its outcome.
METHODS
A retrospective study was conducted in a tertiary care centre from January 2015
to December 2019. All patients who were diagnosed and treated as SPN of
pancreas in our institute were retrospectively reviewed. A data of the
characteristics of these patients was developed, including age, gender, size,
location of tumour, treatment, histopathological and immunohistochemical
features.
RESULTS
Six patients were diagnosed as having SPN of pancreas, during the 5-year period.
All 6 patients were female. Youngest age of occurrence was 15 years. Maximum
age was 41 years. Average age was 25 years. All patients were symptomatic and
the most common symptom was dull aching upper abdominal pain. Contrast
enhanced computed tomography (CECT) was done for all patients. 3 patients had
typical features of SPN. Endoscopic ultrasound (EUS) was done for 4 patients and
EUS fine needle aspiration cytology (FNAC) was done for 3 patients. Patients were
provided with procedure details and informed consent was taken. All patients were
subjected to surgical treatment. Out of six patients, two underwent laparoscopic
spleen preserving distal pancreatectomy, two patients underwent classical
Whipple’s procedure and two patients had undergone median pancreatectomy.
CONCLUSIONS
SPN are rare neoplasms, typically affecting young females without clear
histogenesis and with a malignant potential. Appearance from imaging studies can
be adequate to guide surgical resection without pre-operative pathological
assessment. But in unclear cases, EUS-FNAC with immunohistochemistry helps in
establishing a pre-operative diagnosis. Surgical resection should be offered when
feasible. Prognosis of SPN of the pancreas is good due to its favourable biological
features, even in the presence of distal metastasis.
