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Solid and Papillary Neoplasm of the Pancreas: Emphasis on Surgical Treatment

Solid and Papillary Neoplasm of the Pancreas: Emphasis on Surgical Treatment Abstract • Six Chinese females with solid and papillary neoplasms of the pancreas underwent surgery. Mean age was 26 years. The most common clinical sign was a large palpable abdominal mass. One patient presented with shock and acute onset of abdominal pain with positive peritoneal signs due to rupture of the tumor. The surgical procedures included Whipple's operation in one patient with a tumor at the head of pancreas, a 75% distal pancreatectomy in two patients with tumor of the body or tail of the pancreas, a partial pancreatectomy and pancreaticogastrostomy in one patient with a tumor at the neck and body of the pancreas, total excision in one patient with a tumor of the body of the pancreas, and a Roux-en-Y cystojejunostomy in one patient with a huge unresectable tumor of the head and body of the pancreas. During the follow-up period of from 40 to 83 months, four patients had survived and two had died of causes unrelated to the tumor or surgical procedures. It is important to consider this tumor in the differential diagnosis of a pancreatic mass, especially in young women with long histories of epigastric masses. Resection is the treatment of choice when the tumor is resectable. For unresectable tumors, a bypass procedure might be an alternative. (Arch Surg. 1993;128:433-436) References 1. Compagno J, Oertel JE, Kremzar M. Solid and papillary epithelial neoplasm of the pancreas, probably of small duct origin: a clinicopathologic study of 52 cases . Lab Invest . 1979;40:248-249. 2. Rustin RB, Broughan TA, Hermann RE, Grundfest-Broniatowski SF, Petras RE, Hart WR. Papillary cystic epithelial neoplasms of the pancreas: a clinical study of four cases . Arch Surg . 1986;121:1073-1076.Crossref 3. Fried P, Cooper J, Balthazar E, Fazzini E, Newall J. A role for radiotherapy in the treatment of solid and papillary neoplasm of the pancreas . Cancer . 1985;56:2783-2785.Crossref 4. Todani T, Shimada K, Watanabe Y, Toki A, Fujii T, Urushihara N. Frantz's tumor: a papillary and cystic tumor of the pancreas in girls . J Pediatr Surg . 1988;23:116-121.Crossref 5. Hamoudi AB, Misugi K, Grosfeld JL, Reiner CB. Papillary epithelial neoplasm of pancreas in a child: report of a case with electron microscopy . Cancer . 1970;26:1126-1134.Crossref 6. Morrison DM, Jewell LD, Elliott-McCaughey WT, Danyluk J, Shnitka TK, Manickavel V. Papillary cystic tumor of the pancreas . Arch Pathol Lab Med . 1984;108:723-727. 7. Kaufman SL, Reddick RL, Stiegel M, Wild RE, Thomas CC Jr. Papillary cystic neoplasm of the pancreas: a curable pancreatic tumor . World J Surg . 1986;10:851-859.Crossref 8. Komorn HJ, Zirkin RM, Nathan LE. Papillary cystic neoplasm of the pancreas: report of two cases of a surgically curable tumor . Surgery . 1986; 99:110-113. 9. Sanfey H, Mendelsohn G, Cameron JL. Solid and papillary neoplasm of the pancreas: potential curable surgical lesion . Ann Surg . 1983;197:272-275.Crossref 10. Kuo TT, Su IJ, Chien CH. Solid and papillary neoplasm of the pancreas: report of three cases from Taiwan . Cancer . 1984;54:1469-1474.Crossref 11. Foote A, Simpson JS, Stewart RJ, Wakefield JS, Buchanan A. Diagnosis of the rare solid and papillary epithelial neoplasm of the pancreas by fine needle aspiration cytology: light and electron microscopic study of a case . Acta Cytol . 1986;30:519-522. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Solid and Papillary Neoplasm of the Pancreas: Emphasis on Surgical Treatment

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1993.01420160071011
Publisher site
See Article on Publisher Site

Abstract

Abstract • Six Chinese females with solid and papillary neoplasms of the pancreas underwent surgery. Mean age was 26 years. The most common clinical sign was a large palpable abdominal mass. One patient presented with shock and acute onset of abdominal pain with positive peritoneal signs due to rupture of the tumor. The surgical procedures included Whipple's operation in one patient with a tumor at the head of pancreas, a 75% distal pancreatectomy in two patients with tumor of the body or tail of the pancreas, a partial pancreatectomy and pancreaticogastrostomy in one patient with a tumor at the neck and body of the pancreas, total excision in one patient with a tumor of the body of the pancreas, and a Roux-en-Y cystojejunostomy in one patient with a huge unresectable tumor of the head and body of the pancreas. During the follow-up period of from 40 to 83 months, four patients had survived and two had died of causes unrelated to the tumor or surgical procedures. It is important to consider this tumor in the differential diagnosis of a pancreatic mass, especially in young women with long histories of epigastric masses. Resection is the treatment of choice when the tumor is resectable. For unresectable tumors, a bypass procedure might be an alternative. (Arch Surg. 1993;128:433-436) References 1. Compagno J, Oertel JE, Kremzar M. Solid and papillary epithelial neoplasm of the pancreas, probably of small duct origin: a clinicopathologic study of 52 cases . Lab Invest . 1979;40:248-249. 2. Rustin RB, Broughan TA, Hermann RE, Grundfest-Broniatowski SF, Petras RE, Hart WR. Papillary cystic epithelial neoplasms of the pancreas: a clinical study of four cases . Arch Surg . 1986;121:1073-1076.Crossref 3. Fried P, Cooper J, Balthazar E, Fazzini E, Newall J. A role for radiotherapy in the treatment of solid and papillary neoplasm of the pancreas . Cancer . 1985;56:2783-2785.Crossref 4. Todani T, Shimada K, Watanabe Y, Toki A, Fujii T, Urushihara N. Frantz's tumor: a papillary and cystic tumor of the pancreas in girls . J Pediatr Surg . 1988;23:116-121.Crossref 5. Hamoudi AB, Misugi K, Grosfeld JL, Reiner CB. Papillary epithelial neoplasm of pancreas in a child: report of a case with electron microscopy . Cancer . 1970;26:1126-1134.Crossref 6. Morrison DM, Jewell LD, Elliott-McCaughey WT, Danyluk J, Shnitka TK, Manickavel V. Papillary cystic tumor of the pancreas . Arch Pathol Lab Med . 1984;108:723-727. 7. Kaufman SL, Reddick RL, Stiegel M, Wild RE, Thomas CC Jr. Papillary cystic neoplasm of the pancreas: a curable pancreatic tumor . World J Surg . 1986;10:851-859.Crossref 8. Komorn HJ, Zirkin RM, Nathan LE. Papillary cystic neoplasm of the pancreas: report of two cases of a surgically curable tumor . Surgery . 1986; 99:110-113. 9. Sanfey H, Mendelsohn G, Cameron JL. Solid and papillary neoplasm of the pancreas: potential curable surgical lesion . Ann Surg . 1983;197:272-275.Crossref 10. Kuo TT, Su IJ, Chien CH. Solid and papillary neoplasm of the pancreas: report of three cases from Taiwan . Cancer . 1984;54:1469-1474.Crossref 11. Foote A, Simpson JS, Stewart RJ, Wakefield JS, Buchanan A. Diagnosis of the rare solid and papillary epithelial neoplasm of the pancreas by fine needle aspiration cytology: light and electron microscopic study of a case . Acta Cytol . 1986;30:519-522.

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1993

References