SOLID PSEUDOPAPILLARY NEOPLASM OF THE PANCREAS

Abstract

Summary: Solid pseudopapillary tumors are neoplasms of very low incidence that generally affect young females and have a slow growth pattern, reaching therefore a large size. The majority of them are tumors of low malignant potential. Material and Method: A research was carried out including the cases of the Massachusetts General Hospital (MGH) (1982 to 2006) and the Hospital Edgardo Rebagliati (HNERM) (1991 to 2006), and, in addition, an exhaustive review of worldwide literature was performed. The database included gender, localization, size, invasion and metastasis. Results: During the aforementioned period of time, thirty-one patients were operated on at the MGH and at the HNERM. 87% of these patients were females, being the average age 35.8 years and the average size 7.5 cm. In 57% of the cases the body and tail was the most frequent location. Three patients exhibited local invasion (15.1%) and just one developed hepatic metastasis. The literature was exhaustively reviewed and 630 cases were listed. 89.4% of these cases were females with an average age of 31.2. The average size was 8.2 cm and 57.3% of the neoplasms were located in the body and tail of the pancreas. Local invasion occurred in 11.8% of the cases and 5.9% of the patients presented metastasis. The size was inversely proportional to the age, being the tumors larger in patients under 30 years of age (10.3 cm vs. 7.8 cm) (p = 0.0001). The tumors were more aggressive (higher incidence of metastasis) in patients over 30 years of age (p = 0.042). The size-gender ratio was discovered to be higher among females, with an average of 9.46 cm. in female patients against 6.3 cm in males (p = 0.000). Discussion: Solid pseudopapillary tumors are generally uncommon neoplasms with a low malignancy potential and surgery remains the only therapeutic option. They exhibit a bizarre behavior since age is inversely proportional to their size. They are more aggressive in patients over 30 years of age and there is a predisposition among women, persisting the suspicion that these tumors are influenced by a hormonal stimulus.