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      Solid pseudopapillary neoplasms of the pancreas: Is there a factor determining the prognosis? Experience of a single institution

      research-article
      , MD a , , MD a , * ,
      Medicine
      Lippincott Williams & Wilkins
      mortality, prognosis, recurrence, solid pseudopapillary neoplasia, surgery

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          Abstract

          Solid pseudopapillary neoplasms (SPNs) are frequently seen in young women. Although the behavior pattern varies, these rare lesions generally have a low malignant potential. In this study, the aim was to investigate the effect of clinicopathological features of lesions on the recurrence in and survival of patients. In this study, patients of our clinic who were pathologically diagnosed with SPN after pancreatic surgery between July 2008 and December 2020 were evaluated retrospectively. Patients’ age, gender, comorbidities, symptoms at the time of application, preoperative CA 19-9, CEA value, preoperative cross-sectional diagnostic imaging method and lesion characteristics, surgery, postoperative complications, length of hospital stay, and histopathological features were evaluated. Early and late mortality, overall survival, disease-free survival, and recurrence rate were determined. Four of the 23 patients diagnosed with SPN were male and the median age was 29 (23–47) years. Of the study patients, 69.56% experienced pain symptoms and 30.43% were asymptomatic. The median tumor size was 4 cm (1.5–15). The most common surgical procedure was distal pancreatectomy (56.5%). The median length of hospital stays was 5 (3–120) days and morbidity was observed in 9 cases (39.13%). The mortality rate was 4.35%. The mean follow-up period in the series was 53 (8–132) months and none of the patients developed recurrence. In this study, no significant difference was found regarding recurrence in patients with SPN with histopathologically aggressive biological behavior. The overall survival rate was 95.7%. SPNs are rare lesions with low malignant potential. SPNs are associated with longer-term survival after surgical resection.

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          Most cited references33

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          The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After.

          In 2005, the International Study Group of Pancreatic Fistula developed a definition and grading of postoperative pancreatic fistula that has been accepted universally. Eleven years later, because postoperative pancreatic fistula remains one of the most relevant and harmful complications of pancreatic operation, the International Study Group of Pancreatic Fistula classification has become the gold standard in defining postoperative pancreatic fistula in clinical practice. The aim of the present report is to verify the value of the International Study Group of Pancreatic Fistula definition and grading of postoperative pancreatic fistula and to update the International Study Group of Pancreatic Fistula classification in light of recent evidence that has emerged, as well as to address the lingering controversies about the original definition and grading of postoperative pancreatic fistula.
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            A systematic review of solid-pseudopapillary neoplasms: are these rare lesions?

            The aim of the study was to determine if there had been any change in the number of solid-pseudopapillary neoplasm (SPN) cases detected and their evaluation or management over time.
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              Solid pseudopapillary tumor of the pancreas: a review of 553 cases in Chinese literature.

              To sum up the clinical and pathological characteristics of solid pseudopapillary tumor (SPT) and the experience with it. A total of 553 SPT patients reported in Chinese literature between January 1996 and January 2009 were retrospectively reviewed and analyzed. The mean age of the 553 SPT patients included in this review was 27.2 years, and the male to female ratio was 1:8.37. Their symptoms were non-specific, and nearly one third of the patients were asymptomatic. Computed tomography and ultrasonography were performed to show the nature and location of SPT. Most of the tumors were distributed in the pancreatic head (39.8%), tail (24.1%), body and tail (19.5%). Forty-five patients (9.2%) were diagnosed as malignant SPT with metastasis or invasion. None of the clinical factors was closely related to the malignant potential of SPT. Surgery was the main therapeutic modality for SPT. Local resection, distal pancreatectomy and pancreatoduodenectomy were the most common surgical procedures. Local recurrence and hepatic metastasis were found in 11 and 2 patients, respectively, after radical resection. Four patients died of tumor progression within 4 years after palliative resection of SPT. The prognosis of SPT patients was good with a 5-year survival rate of 96.9%. SPT of the pancreas is a rare indolent neoplasm that typically occurs in young females. It is a low-grade malignancy and can be cured with extended resection. The prognosis of such patients is good although the tumor may recur and metastasize.
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                Author and article information

                Contributors
                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MD
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                26 August 2022
                26 August 2022
                : 101
                : 34
                : e30101
                Affiliations
                [a ] Department of General Surgery, School of Medicine, Uludag University, Gorukle, Bursa, Turkey.
                Author notes
                *Correspondence: Sadik Ayhan Kilicturgay, Department of General Surgery, Uludag University, Gorukle, Bursa/Turkey (e-mail: sturgay@ 123456uludag.edu.tr ).
                Author information
                https://orcid.org/0000-0002-2378-0666
                https://orcid.org/0000-0002-2378-0666
                Article
                00064
                10.1097/MD.0000000000030101
                9410631
                36042645
                8ebde4ff-e213-4b78-948a-19006d88c460
                Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

                History
                : 13 February 2022
                : 27 June 2022
                : 30 June 2022
                Categories
                Research Article
                Observational Study
                Custom metadata
                TRUE

                mortality,prognosis,recurrence,solid pseudopapillary neoplasia,surgery

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