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Solid and papillary epithelial neoplasm of the pancreas in children
1Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-ku, Seoul 110-744, Korea.
Insights
Solid and papillary epithelial neoplasm of the pancreas is a rare, low-grade malignant tumor in children. Complete surgical resection is the recommended treatment, offering a good prognosis with no recurrences observed in this study.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Pancreatic Pathology
Background:
- Solid and papillary epithelial neoplasm (SPEN) of the pancreas is an uncommon, low-grade malignant tumor.
- SPEN predominantly affects young females, but presentation in children is less common and shows a reduced female preponderance compared to adults.
Purpose of the Study:
- To report the clinical characteristics of SPEN in children.
- To evaluate the surgical outcomes and long-term prognosis of pediatric SPEN cases.
Main Methods:
- Retrospective analysis of six pathologically verified cases of pancreatic SPEN in children treated between 1985 and 1997.
- Review of clinical data, surgical procedures, and follow-up information.
Main Results:
- Six pediatric patients (4 female, 2 male, mean age 11.2 years) presented with abdominal masses.
- Tumors ranged in size and were located in the pancreatic head (5 cases) or tail (1 case).
- All patients underwent complete surgical resection (5 pancreaticoduodenectomies, 1 distal pancreatectomy) with no intraoperative mortality, local invasion, or metastasis; all patients were alive with no recurrence after a mean follow-up of 5.5 years.
Conclusions:
- Pancreatic SPEN in children is a low-grade malignancy with a favorable prognosis.
- Complete surgical resection is the treatment of choice for pancreatic SPEN, regardless of tumor location.
- Surgical management of pediatric pancreatic SPEN leads to excellent long-term outcomes.
Abstract:
Solid and papillary epithelial neoplasm of the pancreas is an uncommon low-grade malignant tumor found predominantly in young females. In this paper, the authors report the tumor's clinical characteristics and the results of surgery in six children. Six cases of solid and papillary epithelial neoplasm of the pancreas pathologically verified at Seoul National University Children's Hospital between 1985 and 1997 were retrospectively analyzed. Four were girls and two were boys, and their mean age at surgery was 11.2 years (range 8-13 years). All patients presented with an abdominal mass and tumor ranging in size from 6.5 x 6.0 cm to 10.5 x 8.0 cm. Five were located in the head and one in the tail of the pancreas; exploration showed that no case involved local invasion or metastasis. All patients underwent complete resection, which involved five pancreaticoduodenectomies and one distal pancreatectomy. No patient died during surgery, and after a mean follow-up period of 5.5 years (range 1.5-12.5 years) all were alive with no recurrences. We believe that the malignancy of this tumor is low grade and that the prognosis is good. For a neoplasm arising anywhere in the pancreas, complete resection is the treatment of choice. Solid and papillary epithelial neoplasm of the pancreas of children shows less female preponderance in children than in adults.