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A 20-year review of pediatric pancreatic tumors
1Department of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Pediatric pancreatic tumors are rare but aggressive. Aggressive surgical management offers encouraging long-term outcomes for children with these rare neoplasms.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Pediatric Oncology
Background:
- Pancreatic tumors in children are uncommon and pose significant surgical challenges.
- A 20-year audit identified six pediatric cases of pancreatic neoplasms.
Observation:
- The series included five malignant tumors: three solid cystic tumors, one insulin-secreting tumor, and one pancreatoblastoma.
- Clinical presentations varied, including abdominal pain, hypoglycemia, and abdominal mass with jaundice.
- Preoperative diagnosis of pancreatic pathology was achieved in five of six patients.
Findings:
- All six patients underwent pancreatic resection, with one pancreatoduodenectomy.
- No radiotherapy or chemotherapy was administered.
- The study reported 0% perioperative mortality and 50% morbidity.
Implications:
- Encouraging long-term survival (all patients alive after a mean follow-up of 7.8 years) supports aggressive surgical intervention.
- This study highlights the importance of surgical resection in managing pediatric pancreatic tumors.
- Further research into the optimal management of these rare pediatric malignancies is warranted.
Abstract:
Pancreatic tumors are rare surgical problems in infants and children. A 20-year audit (1971 to 1991) of this institution showed six patients ranging in age from 3 weeks to 16 years who were operated on for pancreatic neoplasms. Five of these tumors were malignant, bringing the reported experience to 71 cases. This series of malignancies included three solid cystic tumors, one insulin-secreting tumor, and one pancreatoblastoma. The clinical presentations varied: three had abdominal pain, one developed hypoglycemia, and one had an abdominal mass with jaundice. In five of the six patients pancreatic pathology was suspected preoperatively. All were treated primarily with pancreatic resection including one pancreatoduodenectomy. No radiotherapy or chemotherapy was used. The perioperative mortality was 0% with a morbidity of 50%. The long-term results are encouraging, with all patients alive after a mean follow-up of 7.8 years. These data suggest that aggressive surgical therapy is warranted in the management of pediatric pancreatic tumors.