Surgically curable pancreas enigma: a single-center experience of solid pseudopapillary neoplasm

BACKGROUND: Solid pseudopapillary neoplasms (SPN) are rare cystic lesions of the pancreas. They are known to have an 'ambiguous behavior' with the potential for metastases and recurrence. The study aims to share the clinical experience with the surgical treatment of SPN. METHODS: A retrospective analysis was conducted on the charts of 20 consecutive SPN patients treated between 1994 and 2019. RESULTS: All patients were female with a median age of 30 years (range 18-67 years). The median tumor size was 6 cm (range 3-16 cm). Tumors were located in the head of the pancreas in 7 patients, in the body in 8, and in the tail in 5. All patients underwent resection with tumorfree surgical margins. Two patients required concomitant vascular resection. Postoperative complications were seen in 7 patients; self-limiting pancreatic fistula in 3 and intraabdominal abscesses in 4. One patient died early after discharge due to an unknown cause, and four were lost to follow-up. The median follow-up period was 130 months (range 20-310). Two patients died of liver metastases at 38 and 70 months following pancreatic resection, and one died of metastatic melanoma without evidence of pancreatic tumor recurrence at 97 months. Twelve patients are alive without any recurrence at a median of 14.5 years (range 1-26). CONCLUSIONS: SPNs are slow -growing tumors with unpredictable potential for malignancy. Surgical resection yields favorable results in terms of survival even in the presence of vascular invasion and metastatic disease. (Cite this article as: Sonmez RE, Buyuk M, Gulluoglu M, Serin K, Ibis AC, Ekiz F, et al. Surgically curable pancreas enigma: a single -center experience of solid pseudopapillary neoplasm. Chirurgia 2024;37:9-14. DOI: 10.23736/S0394-9508.23.05531-6)