Pancreatic solid pseudopapillary neoplasm in male patients: systematic review with three new cases

Updates Surg. 2021 Aug;73(4):1285-1295. doi: 10.1007/s13304-020-00905-4. Epub 2020 Oct 29.

Abstract

Pancreatic solid pseudopapillary neoplasm (pSPN) is a rare exocrine neoplasm, which generally occurs in young women. This study analyses the clinical characteristics of pSPN in male patients through a systematic review of the literature, adding three new cases from our institution. We reviewed our experience in Pspns, and we performed a systematic review of pSPN of all articles published in English in PubMed and SCOPUS from 1980. Using the final included articles, we evaluated clinic-pathological features, surgical treatment and prognosis of male patients affected by pSPN. From the literature review and our cases, we collected 246 male patients with a proven pSPN. Mean age was 34.3 (range 4-78) years, with 26.2% patients younger than 18 years. Patients were asymptomatic in 35.9% of cases, despite a mean tumour size of 6.3 cm. In 63.7% of cases, the pSPN was located in the body-tail region. Distant metastases were reported at diagnosis in only 10 (4.1%) patients. A correct pre-operative diagnosis (including cytopathology) was provided in 53.6% of patients, with only 40 fine-needle aspiration/biopsy performed. Standard pancreatic resections represented 90.4% of surgical procedures. Beta-catenin and progesterone receptors were positive at immunostaining in 100% and 77.8% of cases, respectively. Fourteen (7.2%) patients relapsed after a mean disease-free survival of 43.1 months. After a mean follow-up of 47 (range 4-180) months, 89.5% of patients were alive and disease-free. Although rare, when dealing with a solid-cystic pancreatic mass, even in asymptomatic male patients, a pSPN should be considered as a possible diagnosis.

Keywords: Male patient; Pancreatic surgery; Pancreatic tumour; Solid pseudopapillary neoplasm.

Publication types

  • Case Reports
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy, Fine-Needle
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas
  • Pancreatectomy
  • Pancreatic Neoplasms* / diagnosis
  • Pancreatic Neoplasms* / surgery
  • Young Adult