Background
Solid pseudopapillary neoplasm of the pancreas is a distinctive pancreatic neoplasm
with low metastatic potential. This study examines clinical differences and prognosis
between male and female patients.
Methods
The medical records of 34 consecutive patients with pancreatic solid pseudopapillary
neoplasms between 1990 and 2006 were reviewed. Whenever feasible, organ-preserving
operation was performed. Statistical analysis was performed using chi-square and Student
t test.
Results
There were 27 women (79%) and seven men (21%) with median age of 23 years. Mean diameter
of the tumor was 7 cm. Tumor size tended to be smaller in patients treated in more
recent years. Conservative surgery was possible in 11 patients including spleen-preserving
distal pancreatectomy in 3, central pancreatectomy in 5, and enucleation in 3 patients.
Median hospital stay was 11 days, morbidity rate was 62%, including 17 patients with
grade A pancreatic fistula, and there was no operative mortality. Mean follow-up time
was 84 months. Tumor recurred in 2 patients (6%). Overall late morbidity rate was
12%. At the time of diagnosis, age was ( ± SD) higher among male patients (25 ± 2 years vs 37 ± 7 years; P <.05) with no difference in tumor size. The neoplasms were more aggressive in male
patients; therefore, conservative surgery was less likely. There was no correlation
between tumor aggressiveness and age of the patient or size of tumor.
Conclusion
This is the first single center study to demonstrate that solid pseudopapillary neoplasms
in male patients have distinct patterns of onset and aggressiveness when compared
with female patients. Although valid prognostic criteria are still lacking, it appears
that male patients may be best treated by more radical operation and should be observed
more closely during follow-up.
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Article info
Publication history
Published online: November 05, 2007
Accepted:
July 5,
2007
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
