Aggressive behaviour of solid-pseudopapillary tumor of the pancreas in adults: A case report and review of the literature

Table 1 Patient characteristics

Patient	Sex	Age	Site	Size	Treatment	Follow-up (mo)
1	F	54	Tail	4	DP	A, NED (252)
2	F	13	Body	4	CP	A, NED (171)
3	F	32	Tail	7	DP	A, NED (120)
4	F	31	Tail	14	DP	A, NED (108)
5	F	49	Body-tail	10	TP	A, WD (77)
6	F	20	Tail	10	DP	A, NED (75)
7	F	14	Tail	10	DP	A, NED (48)
8	M	59	Tail	11	DP	A, NED (12)

DP: Distal pancreatectomy; CP: Central pancreatectomy; TP: Total pancreate-ctomy; A: Alive; NED: No evidence of disease; WD: With disease.

Table 2 Treatment and outcome of patients with SPT involving vascular structures

Author	Yr	Sex	Site of infiltration	Therapy	Follow-up (mo)
Sanfey et al[7]a	1982	F	SMV	TP, vascular resection and reconstruction	7, A&W
Dales et al[8]a	1983	F	PV	TP, vascular resection and reconstruction, RT	A&Wd
Fried et al[9]a	1985	F	PV and HA	Unresectable, RT	36, A&W
Matsuda et al[10]a	1987	F	PV and liver metastasis	Unresectable, Chemoembolization, CT	60, AWD
Matsunou & Konishi[11]a	1990	F	PV and peritoneal dissemination	Unresectable, RT & CT	47, DOD
Zinner et al[12]a	1990	F	PV	DP, vascular resection and reconstruction	48, A&W
	1990	F	PV	TP, vascular resection and reconstruction	84, A&W
Tsunoda et al[13]a	1991	M	PV	Whipple, vascular resection and reconstruction	22, A&W
Nishihara et al[14]a	1993	F	Venous invasion	Resectedb	3, A&W
		F	Venous invasion	Resectedb	13, A&W
		F	PV	Whipple, vascular resection and reconstruction	66, DUC
Jeng et al[15]a	1993	F	PV and SMA	Unresectable, Roux-en-Y cystojejunostomy	83, DUC
		F	PV	Whipple, vascular resection and reconstruction	40, A&W
Saiura et al[16]	2000	F	PV with thrombus, liver metastases	DP with splenectomy, extended right lobectomy, partial resection of the liver, vascular resection	8, A&W
Martin et al[17]	2002	NA	SMA encasement	Unresectable	156, alive
		NA	SMA encasement	Unresectable	12, alive
Goh et al[18]c	2003	F	PV	PD, vascular resection and reconstruction	67, NED
Podevin J[20]	2003	F	SMV	PD, vascular resection and reconstruction, segmental colectomy	12, A&W
Usatoff et al[21]	2004	F	SMV	PD, vascular resection and reconstruction	5, NED
Hassan et al[22]	2005	F	PV, colon	PD, vascular resection and reconstruction. Enucleation of liver metastases after 12 mo	18, NED
Chen et al[23]	2005	F	PV, liver metastasis.	Resection of both primary and metastatic lesions and the portal vein	36, A&W
Frago et al[24]	2006	F	PV	Duodenum preserving subtotal pancreatectomy, vascular resection and reconstruction	76, A&W
Hao et al[25]	2006	F	SMA, SMV	Unresectable, internal drainage	8, NED
Zauls et al[26]	2006	F	PV and SMV	Unresectable, RT	18, alive
Tipton et al[27]	2006	NA	SMV	Unresectable, gastroenteroanastomosis	92, DOD
Cheng-Hong et al[28]	2006	F	PV	PD, vascular resection and reconstruction	> 12, NA
		F	SMV	PD, vascular resection and reconstruction	> 12, NA
Present case	2007	F	SMV	TP, vascular resection and reconstruction, CT	77, AWD

^aPatients included in Mao's review[3];

^bPatients erroneously included as vascular invasion, histological venous invasion was only present; ^cPreviously reported by NG et al[18]; ^dDuration of follow-up not stated; SMA: Superior mesenteric artery; HA: Hepatic artery; PV: Portal vein; SMV: Superior mesenteric vein; RT: Radiotherapy; CT: Chemotherapy; PD: Pancreaticoduodenectomy; DP: Distal pancreatectomy; TP: Total pancreatectomy; NED: No evidence of disease; NA: Not available; DUC: Died of unrelated cause; AWD= Alive with disease.

Table 3 Patients with recurrent disease after potentially curative resection

Author	Yr	Extrapancreatic disease at diagnosis	Therapy	Site, time of recurrence (mo), therapy	Mo from 1st recurrence & follow-up
Levy et al[29]	1997	Peritoneal metastases	DP, Omentectomy, lymphadenectomy	Peritoneal carcinomatosis (8): complete resection. Liver (16)	29, AWD
Shimizu et al[30]	1999	No	DP	Liver (17)	3, DOP
Rebhandl et al[31] Martin et al[17]	2001 2002	No	SPDP	Peritoneum-omentum (24) radical resection. Spleen, peritoneum (36) tumor debulking; CT. Recurrence lesser omentum (>72) tumor resection, interferon.	> 54, NED
		Liver	Resection	Liver, NA	8, DOD
		Liver	Resection	Liver, NA	72, AWD
Gedaly et al[32]	2002	no	DCP	Liver (36), hepatectomy; liver (72), RF	48, AWD
Tang et al[33] Takahashi et al[34]	2005 2005	No Liver (multiple nodules)	DCP DP, adrenalectomy & enucleation of 38 hepatic nodules	Liver, (3)	13, DOD 46, AWD
				Liver (14, 27, 38)/enucleation of 14, 21, 19 nodules;
				lung (41)/ lung resection
Huang H-L et al[35] Kang et al[36]	2005 2006	No Peripancreatic nodes	SPDP DP	Liver (168)	10, DOD 17, DOD
				Liver, CT, TACE,( 9),
				Surgery + RF
Tipton et al[27] Cao et al[37]	2006 2006	Incomplete resection	DP	Subcutaneous (14): removed; intra-abdominal recurrences removed (?)	94, NED
		no	UR	Liver, (57)	3, DOD
		no	UR	Liver, (72)	0, AWD
		no	UR	Liver (11), resection	110, NED
Adamthwaite et al[38]	2006	nodes	DCP	Liver (2)	0.5, DOD
Nagri et al[39]	2007	duodenum	Resection	Liver (48)	48, AWD
Present patient	2007	No	Resection	Liver (32), CT	45, AWD

SPDP: Spleen preserving distal pancreatectomy; DP: Distal pancreatectomy; PD: Pancreaticoduodenectomy; UR: Unspecified resection; TACE: Transarterial chemoembolization; CT: Chemotherapy; RF: Radiofrequency; NA: Not available; DOD: Died of disease; DOP: Died of procedure (TAE); AWD: Alive with disease; NED: No evidence of disease.