Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2021; 13(6): 589-599
Published online Jun 15, 2021. doi: 10.4251/wjgo.v13.i6.589
Yield of surgery in solid pseudopapillary neoplasms of the pancreas: A case series and literature review
Flávio Silano, Ricardo Bandeira de Melo Amaral, Rodolfo Carvalho Santana, Vanessa Costa Neves, José Celso Ardengh, Paulo Cezar Galvão do Amaral
Flávio Silano, Digestive Surgery, Hospital São Rafael/Rede D’Or, Salvador 40285000, Bahia, Brazil
Ricardo Bandeira de Melo Amaral, Rodolfo Carvalho Santana, Vanessa Costa Neves, Paulo Cezar Galvão do Amaral, Department of Surgery of the Upper Digestive System, São Rafael Hospital/Rede D’Or Hospital Group, Salvador 41253-190, Bahia, Brazil
José Celso Ardengh, Surgery and Anatomy, Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo, São Paulo 04611-000, São Paulo, Brazil
José Celso Ardengh, Endoscopy Service, Hospital 9 de Julho, São Paulo 04611-000, São Paulo, Brazil
José Celso Ardengh, Imaging and Diagnosis, Escola Paulista de Medicina - São Paulo Federal University, São Paulo 04611-000, SP, Brazil
Author contributions: All authors contributed to review and writing the manuscript equally; Silano F, de Melo Amaral RB, Santana RC, Neves VC, Ardengh JC, do Amaral PCG all approved the final version.
Institutional review board statement: Approval Obtained from Institutional Reivew Board of “Hospital São Rafael/Rede D’Or Ethics and Research Committee; Approval No. 35555820.0.0000.0048; Approval Date: 28/07/2020.”
Informed consent statement: This is not applicable. The authors’ own database was used. There is no clinical trial, there is no drug test, and there is no exposure of patients.
Conflict-of-interest statement: None of the Authors has any conflict of interest related to the manuscript.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Flávio Silano, MD, Medical Assistant, Surgeon, Surgical Oncologist, Digestive Surgery, Hospital São Rafael/Rede D’Or, Av São Rafael 2152, São Marcos, Salvador 40285000, Bahia, Brazil.
Received: November 3, 2020
Peer-review started: November 3, 2020
First decision: January 29, 2021
Revised: March 24, 2021
Accepted: May 7, 2021
Article in press: May 7, 2021
Published online: June 15, 2021

Solid pseudopapillary neoplasms (SPN) of the pancreas represents approximately 2% of non-endocrine tumors of the pancreas. It is described in the literature as a rare and predominant tumor in young women.


To report a case series with SPN and analyzing clinical, surgical, anatomopathological characteristics, as well as the prognosis and review of literature.


Retrospective analysis of patients undergoing surgery, with histological diagnosis of SPN between 1998 and 2018, using standardized and prospectively completed forms, performed at the Surgery Service of the Upper Digestive System at Hospital São Rafael/Rede D’Or in Salvador - BA. Review of literature through a database search in MEDLINE/PubMed of retrospective articles.


Fourteen female patients with the average age of 31.6 years (range min-max) were selected. Twelve patients (85.7%) were asymptomatic, being an incidental diagnosis or due to screening for other reasons. One patient had abdominal pain due to gastric compression and another patient had jaundice. The 14 patients were staged with computerized tomography or magnetic resonance imaging. None had evidence of metastasis. In 8 patients (57.1%), the tumor was in the tail and body. The average size was 6.7 cm (range min-18). The type of surgery was according to the anatomical location of the tumor. There was no lymph node involvement. In two cases, vascular resection with the use of a prosthesis was required for reconstruction. The surgical margins were free. In all cases, postoperative immunohistochemistry confirmed that it was a solid pseudo-papillary neoplasia of the pancreas. There has been no disease recurrence in any case so far.


The tumors had a benign, indolent and histopathological behavior compatible with the literature. Curative surgery is recommended in all cases.

Keywords: Frantz tumor, Malignancy, Solid pseudo-papillary tumor, Surgical treatment, Survival, Pancreas

Core Tip: Surgery is the only curative treatment for solid papillary neoplasm of the pancreas. Even in cases of large tumors, wherein extensive resections of both the main tumor and the metastases are an absolute requirement, surgery can be curative and allow a long, disease-free survival. Some of the patients in the service studied underwent tumor resection more than 13 years ago, without relapse of the disease and maintaining a good quality of life. This type of neoplasm is considered rare, but in the present study most cases were discovered incidentally through imaging examinations, with the number of cases increasing since 2012.