Clinical diagnosis and treatment analysis of solid pseudopapillary neoplasm of the pancreas in children: a report of 16 cases
10.3760/cma.j.cn113884-20240711-00206
- VernacularTitle:儿童胰腺实性假乳头状瘤16例临床诊治分析
- Author:
Denghui LIU
1
;
Yong LI
1
;
Ming LI
1
;
Xianglian TANG
1
Author Information
1. 中南大学湘雅医学院附属儿童医院（湖南省儿童医院）普外科，长沙 410000
- Publication Type:Journal Article
- Keywords:
Child;
Pancreatic neoplasms;
Diagnosis;
Surgical procedures, operative;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(1):38-42
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the strategies in the diagnosis and treatment of solid pseudopapillary neoplasm (SPN) of the pancreas in children.Methods:The clinical data of 16 children with SPN managed at the Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital) from January 2015 to December 2022 were retrospectively studied. There were 9 males and 7 females, ranged from 7 years and 5 months to 13 years and 3 months, with a median age of 10 years and 7 months. The clinical performance and types of the tumor (type Ⅰ, tumor located in the tail of pancreas; Type Ⅱ, the tumor located in the pancreatic body; Type Ⅲ, tumor located in the head of the pancreas), surgical methods, complications (pancreatic fistula, intestinal obstruction, hemorrhage) were analyzed. The recurrence was followed up by outpatient review or telephone after surgery.Results:The main clinical characteristics included abdominal pain (12 cases), abdominal trauma examination findings (2 cases), and physical examination findings (2 cases). The results of abdominal ultrasound, enhanced CT and/or MRI examinations showed that 4 cases of cystic tumors, 7 cases of solid tumors, and 5 cases of cystic solid tumors. Among of all patients, 2 cases were clinical classification type Ⅰ, 8 cases were type Ⅱ, and 6 cases were type Ⅲ. Among 6 cases with tumor located in the head of the pancreas, 3 patients underwent pancreaticoduodenectomy, 1 patient underwent resection of the head of the pancreas with preservation of the duodenum, 1 patient underwent laparoscopic resection of pancreatic head tumor, 1 patient underwent biopsy of pancreatic head tumor. The other 10 cases with tumor located in the body and tail of the pancreas, 6 patients underwent laparoscopic splenic preservation pancreatic body-tail resection, 1 patient underwent laparoscopic resection of pancreatic body-tail and splenectomy, combined with autologous splenic transplantation, 1 patient underwent laparoscopic removal of the splenic venous thrombus, splenic preservation pancreatic body-tail, 1 patient underwent laparoscopic enucleation of a dorsal tumor in the middle part of the pancreas, and 1 patient underwent open resection of spleen-preserving pancreatic body-caudal. Postoperative complications included pancreatic fistula (grade B) with massive hemorrhage (1 case), biochemical leakage (1 case), post-operative pancreatitis (1 case), intestinal obstruction (1 case), and reactive thrombocytosis (1 case). The patient pancreatic fistula (grade B) with massive hemorrhage and pancreatic leakage required emergency surgery, while the remaining patients recovered with conservative treatment. All patients were followed up for 22 to 90 months (median follow-up period of 70 months), two cases relapsed and were successfully re-treated surgically at 36 months and 33 months post-surgery, respectively. One patient with high grade transformation SPN and obstructive jaundice withdrew treatment (missed follow-up), while the remaining patients without recurrence after surgery.Conclusion:Children SPN has no specific clinical features, and preoperative abdominal ultrasound, CT and/or MRI can be located and diagnosed. Surgery is the preferred treatment, and the prognosis is well.
