Clinical update on the management of pseudopapillary tumor of pancreas

Abstract

Solid pseudopapillary neoplasm (SPN) is a rare tumor with malignant potential which is generally located in the tail of pancreas. The prevalence of SPN has increased with widespread use of cross sectional imaging. SPN is often misdiagnosed due to nonspecific clinical presentation and accurate diagnosis is essential for optimal management. Endoscopic ultrasound-FNA with immunohistochemistry can help in preoperative diagnosis. Surgery is the treatment of choice and a successful R0 resection is curative. Overall, SPN has a good prognosis. This review article focuses on pathogenesis, diagnosis and management of SPN.

Keywords: Pancreatectomy; Pancreatic cysts; Beta-catenin; Endoscopic ultrasound-fine needle aspiration; E-cadherin; Immunohistochemistry

Core tip: Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor that predominantly affects young females. SPNs are usually indolent but they do have malignant potential. The pathogenesis of SPN is not entirely clear. Accurate diagnosis is essential in the management of SPN. Endoscopic ultrasound guided fine needle aspiration with immunohistochemistry can help distinguish SPNs from other aggressive pancreatic tumors preoperatively. Surgical resection with clear margins is curative and should be offered whenever feasible. The prognosis of SPN is good even in the presence of metastasis.