Solid pseudopapillary tumors of the pancreas. Pathology report in 13 cases.

Objectives. - Solid pseudopapillary tumors of the pancreas are exceptional. The aims of our study were to reevaluate the mode of presentation of these rumors and to analyze the role of pathological examination in diagnostic a ssessment and prognostic evaluation. Patients. - We report the clinical, radiological and pathological findings in a retrospective series of 13 patients in whom a diagnosis of solid pseud opapillary tumor of the pancreas was made between 1983 and 1997. There were 12 females (median age : 22.5 years) and one male, aged 73. Results. - The ruiner was discovered incidentally (3 cases) or because of n onspecific digestive symptoms (10 cases). Biological data were uninformativ e. The tumor was pancreatic in 12 cases and duodenal in 1. In all cases, im aging techniques silo,red an heterogeneous lesion with no or poor vasculari zation. A cystic component was identified in 4 cases. Surgical resection wa s performed in all cases. Pathological examination showed an encapsulated t umor in 8 cases, a non-encapsulated but well-limited lesion in 3 cases and an infiltrative tumor. in 2 cases. Al the time of diagnosis, multiple liver metastases were present in 1 case. Mean duration of follow-up was 24 month s (range : 3-168). At last follow-up, all patients, including the patient w ith synchronous metastatic disease, were alive, without local recurrence. Conclusion. - Our study confirms that most cases of solid pseudopapillary t umors of the pancreas present with a suggestive clinical picture, including their occurrence in young women and their good prognosis after surgical re section, However; our results also underline the occurrence of cases presen ting with unusual features, including old age, male sex extra-pancreatic lo calization and malignant evolution. Histopathological examination is essent ial for the establishment of the diagnosis but morphological data are of li ttle prognostic value.