Differential diagnosis of solid pseudopapillary tumors of the pancreas
Abstract
The purpose of the study – the most critical differential-diagnostic criteria of solid pseudopapillary tumors (SPPT) of the pancreas.
Material and methods. There has been analyzed the results of examination and treatment of 24 patients with solid pseudopapillary tumors of the pancreas, who were impatiently treated in the Federal State Budget Institution “A.V. Vishnevsky Institute of Surgery” of the Ministry of Health of the Russian Federation in the period of time from the January 1, 2010, to April 30, 2016.
Results. According to histological examination the SPPT was diagnosed in 20 (83.3%) observa- tions, immunophenotype characteristically common for SPPT confirmed by immunohistochemical study for all the patients. According to instrumental examination methods the SPPT was reported in 36.8% of patients according to ultrasound (US) data, 60% – according to endoscopic US, 77.8% according to MSCT data, 72.7% according to MRI data.
Discussion. Preoperative diagnosis of the SPPT is critically important, the frequency of misdiagnosis is up to 38%. Differential diagnosis should be built on descriptions aggregation criteria, that were received on different scanning methods.
Conclusions. The detection in young women patients (up to 40 years old) of heterogeneous structured tumor with calcifications and liquid component without pancreatic hypertension, that is hypoechoic (according to US examination), hypodense during the arterial phase of the contrast enhancement (on MSCT), with possibility of 82.3% may indicate the presence of solid pseudopapillary tumor.
Keywords:solid pseudopapillary tumor, differential diagnosis, pancreatic tumor
Clin. Experiment. Surg. Petrovsky J. 2018; 6 (2): 40–7.
doi: 10.24411/2308-1198-2018-12005. Received: 18.10.2017. Accepted: 20.04.2018.
References
1. Martin R.C., Klimstra D.S., Brennan M.F., Conlon K.C. Solid pseudopapillary tumor of the pancreas: a surgical enigma? Ann Surg Oncol. 2002; 9: 35–40.
2. Mulkeen A.L., Yoo P.S., Cha C. Less common neoplasms of the pancreas. World J Gastroenterol. 2006; 12: 3180–5.
3. Klоppel G., Hruban R.H., Klimstra D.S., Maitra A., et al. Solid- pseudopapillary tumor of pancreas. World Health Organization Classi- fication of Tumours of the digestive system. Lyon: IARC, 2010: 327–30.
4. Bosman F.T., Carneiro F., Hruban R.H., Theis N.D. WHO Classification of Tumours of the Digestive System. V3 (IARC WHO Classification of Tumours). 4th ed. World Health Organization, 2010: 417 p.
5. Singh P., Patel K., Ramakrishna B. Solid pseudopapillary tumor of the pancreas: a retrospective analysis of 36 cases from a single institution in India. Indian J Cancer. 2015; 52 (3): 439–42.
6. Cai Y., Ran X., Xie S., Wang X., et al. Surgical management and long-term follow-up of solid pseudopapillary tumor of pancreas: a large series from a single institution. J Gastrointest Surg. 2014; 18 (5): 935–40.
7. Stepanova Yu.A., Shchegolev A.I., Karmazanovskiy G.G., Dubova E.A., et al. Solid pseudopapillary tumors of the pancreas: diagnosis and treatment. Khirurgiya [Surgery]. 2009; (9): 29–40. (in Russian)
8. Yang F., Jin C., Long J., Yu X.J., et al. Solid pseudopapillary tumor of the pancreas: a case series of 26 consecutive patients. Am J Surg. 2009; 198: 210–5.
9. Mirminachi B., Farrokhzad S., Sharifi A.H., Nikfam S., et al. Solid pseudopapillary neoplasm of pancreas: a case series and review literature. Middle East J Dig Dis. 2016; 8: 102–8.
10. Yamaguchi1 M., Fukuda T., Nakahara M. Multicentric solid pseudopapillary neoplasms of the pancreas diagnosed by endoscopic ultrasound-guided fine needle aspiration: a case report Yamaguchi et al. Surg Case Rep. 2015; 1: 110.
11. Reddy A., Sanniyasi S., George D.J., Narayanan C.D. A rare case report of Solid Pseudopapillary Tumor of the pancreas with portal hypertension. Int J Surg Case Rep. 2016; 22: 35–8.
12. Gordienko E.N., Paklina O.V., Chekmareva I.A., Gorin D.S. A solid pseudopapillary tumor of the pancreas. Topical clinical-morphological and molecular-biological aspects. Khirurgiya. Zhurnal im. N.I. Pirogova [Surgery. The Journal Named after N.I. Pirogov]. 2013; (8): 70–5. (in Russian)
13. Tang L.H., Aydin H., Brennan M.F., Klimstra D.S. Clinically aggressive solid pseudopapillary tumors of the pancreas: A report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases. Am J Surg Pathol. 2005; 29: 512–9.
14. Yu P.F., Нu Z.H., Wang X.B., Guo J.M., et al. Solid pseudo- papillary tumor of the pancreas: a review of 553 cases in the Chinese literature. World J Gastroenterol. 2010; 16: 1209–14.
15. Tipton S.G., Smyrk T.C., Sarr M.G. Thompson G.B. Malig- nant potential of solid pseudopapillary neoplasm of the pancreas. Br J Surg. 2006; 93: 733–7.
16. Gurevich L.E., Kazantseva I.A., Sokolova I.N., Korsa- kova N.A., et al. Clinico-morphological characteristics, features of immunophenotype, diagnostic problems of solid pseudopapillary pancreatic tumors. Arkhiv patologii [Archive of Pathology]. 2014; 76 (5): 44–54. (in Russian)
17. Papavramidis T. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. J Am Coll Surg. 2005; 200 (6): 965–72.
18. Chen C., Jing W., Gulati P., Vargas H., et al. Melanocytic differentiation in a solid pseudopapillary tumor of the pancreas: case report. J Gastroenterol. 2004; 39: 579–83.
19. Chen X., Zhou G.W., Zhou H.J., Peng C.H., et al. Diagnosis and treatment of solid-pseudopapillary tumors of the pancreas. Hepatobiliary Pancreat Dis Int. 2005; 4 (3): 456–9.
20. Yu C.C., Tseng J.H., Yeh C.N. Hwang T.L., et al. Clinicopathological study of solid and pseudopapillary tumor of pancreas: emphasis on magnetic resonance imaging findings. World J Gastroenterol. 2007; 13: 1811–5.
21. ZhengX.,TanX.,WuB.CTimagingfeaturesandtheircorrela- tion with pathological findings of solid pseudopapillary tumor of pancreas. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2014; 31 (1): 107–12.
22. Fujii M., Saito H., Kato H. Diagnosis of a solid pseudopapillary neoplasm using EUS-FNA. Intern Med. 2013; 52: 1703–8.
23. Ren Z., Zhang P., Zhang X., Liu B. Solid pseudopapillary neoplasms of the pancreas: clinico-pathologic features and surgical treatment of 19 cases. Int J Clin Exp Pathol. 2014; 7: 6889–9.
24. Ventriglia A., Manfredi R., Mehrabi S., Bonin-Segna E., et al. MRI features of solid pseudopapillary neoplasm of the pancreas. Abdom Imaging. 2014; 39: 1213–20.
25. Vassos N., Agaimy A., Klein P. Solid-pseudopapillary neoplasm (SPN) of the pancreas: case series and literature review on an enigmatic entity Int J Clin Exp Pathol. 2013; 6 (6): 1051–9.
26. Ansari N.A., Ramalho M., Semelka R.C., Buonocore V., et al. Role of magnetic resonance imaging in the detection and characterization of solid pancreatic nodules: an update. World J Radiol. 2015; 7 (11): 361–74.