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Category: Volume 06 Issue 10 October 2018
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Title: An analysis of management of solid pseudopapillary neoplasms of Pancreas in a tertiary centre: 10 years experience

Authors: Kamalakannan Rajendran, Sugumar Chidambaranathan, Jeswanth Sathyanesan,  Ravichandran Palaniappan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.78

Abstract

Background & Aim: Solid pseudo papillary neoplasm (SPN) is a rare tumor of the pancreas. The present study was aimed to evaluate the clinical and pathologic characteristics and surgical outcomes of SPNs.

Methods: The clinical data of patients with SPN presented to surgical Gastroenterology Department between 2008 and 2018 were evaluated retrospectively. Clinical and pathological features, radiological findings, surgical intervention, & follow up details were reviewed.

Results:  In this study, 18 cases of SPN were identified and prevalence of female was high (16 cases) when compared to the males. The mean age of the cases were 23 years.  Predominant symptom was low grade abdominal pain. Among the 18 cases, 12 cases displayed both solid cystic components, 3cases were solid tumors and the remaining 3 cases were cystic tumor. Based on the clinical and radiological findings 12 cases were confirmed for SPN. Further, surgical management was done in all cases and distal pancreatectomy was done in 12cases, whipples surgery in 3 cases , spleen preserving laparoscopic distal pancreatectomy in 1 case, central pancreatectomy in 1case and one case underwent multi organ resection. Six cases with uncertain diagnosis were confirmed by immunohistochemistry. There was one recurrence in patients who underwent multi organ resection and no mortality was observed in our study.

Conclusion: SPN is a rare tumor that develops principally in young women and has a good prognosis. Preoperative diagnosis of SPN is possible in most of the cases based on clinical and radiological features. Surgical resection is the best management. Generally SPNs are associated with long term survival even in advanced stage.

Keywords: Solid pseudo papillary neoplasm, distal pancreatectomy, Central pancreatectomy, Immunohistochemistry (IHC), EUS (Endo ultrasound).

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Corresponding Author

Dr Kamalakannan Rajendran

Senior Assistant Professor, Institute of Surgical Gastroenterology & Liver Transplant, Govt. Stanley Medical College Hospital, Chennai, Tamil Nadu-600001, India

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