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Enucleation of solid pseudopapillary tumor with a preoperative nasopancreatic drainage stent in a child
Keiichiro Tanaka1, Takeyuki Misawa1, Koichiro Haruki1
1Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.
Insights
Enucleation of pediatric solid pseudopapillary tumors (SPT) is feasible. Preoperative endoscopic nasopancreatic drainage stent placement enhances safety by preventing main pancreatic duct injury during tumor removal.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Oncology
Background:
- Solid pseudopapillary tumor (SPT) is a rare, low-grade malignant pancreatic neoplasm predominantly affecting children.
- Complete surgical resection is curative, with enucleation being a viable option.
- Main pancreatic duct injury is a significant complication during enucleation.
Observation:
- A 10-year-old girl with SPT underwent tumor enucleation.
- An endoscopic nasopancreatic drainage stent (NPDS) was placed preoperatively to aid in avoiding and detecting main pancreatic duct injury.
- The enucleation was performed successfully with NPDS guidance.
Findings:
- This case represents the first successful enucleation of an SPT in a child utilizing a preoperative NPDS.
- The NPDS facilitated safe tumor removal by providing real-time guidance and protection for the main pancreatic duct.
Implications:
- Preoperative NPDS placement may represent a valuable technique for improving the safety and efficacy of pancreatic tumor enucleation in pediatric patients.
- This approach could minimize the risk of major ductal complications, leading to better surgical outcomes for rare pancreatic tumors like SPT.
Abstract:
Solid pseudopapillary tumor (SPT) is a rare pancreatic tumor with low-grade malignancy in children. A complete surgical resection can achieve a favorable prognosis. Although several reports have indicated that enucleation is considered a safe and effective treatment, the most significant complication is injury to the main pancreatic duct. The usefulness and safety of tumor enucleation after preoperative placement of an endoscopic nasopancreatic drainage stent (NPDS) has recently been reported. We present the case of SPT in a 10-year-old girl. To avoid and detect injury to the main pancreatic duct during operation, an NPDS was endoscopically placed before laparotomy. The patient underwent a complete enucleation of the tumor with the guidance of an NPDS. Our case is the first report of a successful enucleation of an SPT with a preoperative placement of an NPDS. This procedure may lead to safe enucleation of a pancreatic tumor with low malignancy, such as SPT, in children.
