Solid-pseudopapillary tumor of the pancreas (SPT) or Frantz’s tumor is a rare epithelial neoplasm that represents 0.3% to 2.7% of exocrine pancreatic tumors. These tumors occur mainly in young women and have a good p...Solid-pseudopapillary tumor of the pancreas (SPT) or Frantz’s tumor is a rare epithelial neoplasm that represents 0.3% to 2.7% of exocrine pancreatic tumors. These tumors occur mainly in young women and have a good prognosis. We present a case of a 19-year-old female patient who presented to the emergency for abdominal pain. Physical examination reveals a left hypochondrium mass. Ultrasound imaging showed an encapsulated caudal pancreatic mass with cystic components. The patient underwent tumor excision and lymph node removal. Macroscopically, the tumor was encapsulated and measuring 12 × 8 × 7 cm. It has a solid-cystic and hemorrhagic appearance inside. Histologically, the tumor had two components: solid and papillary. Tumor tissue showed monomorphic tumor cells radiating around blood vessels. Perineural invasion and vascular emboli were not seen. Three lymph nodes without metastases were observed. The diagnosis of solid-pseudopapillary tumor of the pancreas (SPT) or Frantz’s tumor was retained. Solid-pseudo-papillary tumor of the pancreas is rare and not always suspected by the physician. The clinical and imaging patterns are not specific. Anatomopathological examination confirmed the diagnosis. The patient underwent curative surgery.展开更多
BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant potential.Endoscopic ultrasound(EUS)assessment plays a vital role in lesion characterization and conf...BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant potential.Endoscopic ultrasound(EUS)assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis.However,there is a paucity of data regarding the imaging assessment of these lesions.AIM To determine the characteristic EUS features of SPN and define its role in preoperative assessment.METHODS This was an international,multicenter,retrospective,observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers.All cases with postoperative histology of SPN were included in the study.Data collected included clinical,biochemical,histological and EUS characteristics.RESULTS One hundred and six patients with the diagnosis of SPN were included.The mean age was 26 years(range 9 to 70 years),with female predominance(89.6%).The most frequent clinical presentation was abdominal pain(80/106;75.5%).The mean diameter of the lesion was 53.7 mm(range 15 to 130 mm),with the slight predominant location in the head of the pancreas(44/106;41.5%).The majority of lesions presented with solid imaging features(59/106;55.7%)although 33.0%(35/106)had mixed solid/cystic characteristics and 11.3%(12/106)had cystic morphology.Calcification was observed in only 4(3.8%)cases.Main pancreatic duct dilation was uncommon,evident in only 2 cases(1.9%),whilst common bile duct dilation was observed in 5(11.3%)cases.One patient demonstrated a double duct sign at presentation.Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern.EUS guided biopsy was performed using three different types of needles:Fine needle aspiration(67/106;63.2%),fine needle biopsy(37/106;34.9%),and Sonar Trucut(2/106;1.9%).The diagnosis was conclusive in 103(97.2%)cases.Ninety-seven patients were treated surgically(91.5%)and the post-surgical SPN diagnosis was confirmed in all cases.During the 2-year follow-up period,no recurrence was observed.CONCLUSION SPN presented primarily as a solid lesion on endosonographic assessment.The lesion tended to be located in the head or body of the pancreas.There was no consistent characteristic pattern apparent on either elastography or Doppler assessment.Similarly SPN did not frequently cause stricture of the pancreatic duct or common bile duct.Importantly,we confirmed that EUS-guided biopsy was an efficient and safe diagnostic tool.The needle type used does not appear to have a significant impact on the diagnostic yield.Overall SPN remains a challenging diagnosis based on EUS imaging with no pathognomonic features.EUS guided biopsy remains the gold standard in establishing the diagnosis.展开更多
AIM:To investigate the clinical characteristics,surgical strategies and prognosis of solid pseudopapillary tumors(SPTs)of the pancreas in male patients.METHODS:From July 2003 to March 2013,116 patients were diagnosed ...AIM:To investigate the clinical characteristics,surgical strategies and prognosis of solid pseudopapillary tumors(SPTs)of the pancreas in male patients.METHODS:From July 2003 to March 2013,116 patients were diagnosed with SPT of the pancreas in our institution.Of these patients,16 were male.The patients were divided into two groups based on gender:female(group 1)and male(group 2).The groups were compared with regard to demographic characteristics,clinical presentations,surgical strategies,complications and follow-up outcomes.RESULTS:Male patients were older than female patients(43.1±12.3 years vs 33.1±11.5 years,P=0.04).Tumor size,location,and symptoms were comparable between the two groups.All patients,with the exception of one,underwent complete surgical resection.The patients were regularly followed up.Themean follow-up period was 58 mo.Two female patients(1.7%)developed tumor recurrence or metastases and required a second resection,and two female patients(1.7%)died during the follow-up period.CONCLUSION:Male patients with SPT of the pancreas are older than female patients.There are no significant differences between male and female patients regarding surgical strategies and prognosis.展开更多
BACKGROUND 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.AIM To...BACKGROUND 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.AIM To report a case series with SPN and analyzing clinical,surgical,anatomopathological characteristics,as well as the prognosis and review of literature.METHODS 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.RESULTS 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.CONCLUSION The tumors had a benign,indolent and histopathological behavior compatible with the literature.Curative surgery is recommended in all cases.展开更多
Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to per...Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic SPTs.Data sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)standards.Primary endpoints were to analyze treatments and oncological outcomes.Results:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion criteria.Overall,1384 patients underwent pancreatic surgery.Mean age was 30 years and 1181 patients(85.3%)were female.The most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 years.Conclusions:Pancreatic SPTs are rare,and predominantly affect young women with unclear pathogenesis.Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.展开更多
We have optimized the input pulse width and injection time to achieve the highest possible output pulse energy in a double-pass laser amplifier using two Nd:YAG rods. For this purpose, we have extended the Frantz–Nod...We have optimized the input pulse width and injection time to achieve the highest possible output pulse energy in a double-pass laser amplifier using two Nd:YAG rods. For this purpose, we have extended the Frantz–Nodvik equation by simultaneously including both spontaneous emission and pump energy variation. The effective pump energy of the flash lamp was 8.84 J for each gain medium. The energy of 1 J could be amplified to an output energy of 12.17 J with the maximum achieved extraction efficiency of 63.18% when an input pulse having a pulse width of 168 μs is sent 10 μs after the absorbed pump energy becomes the maximum value.展开更多
文摘Solid-pseudopapillary tumor of the pancreas (SPT) or Frantz’s tumor is a rare epithelial neoplasm that represents 0.3% to 2.7% of exocrine pancreatic tumors. These tumors occur mainly in young women and have a good prognosis. We present a case of a 19-year-old female patient who presented to the emergency for abdominal pain. Physical examination reveals a left hypochondrium mass. Ultrasound imaging showed an encapsulated caudal pancreatic mass with cystic components. The patient underwent tumor excision and lymph node removal. Macroscopically, the tumor was encapsulated and measuring 12 × 8 × 7 cm. It has a solid-cystic and hemorrhagic appearance inside. Histologically, the tumor had two components: solid and papillary. Tumor tissue showed monomorphic tumor cells radiating around blood vessels. Perineural invasion and vascular emboli were not seen. Three lymph nodes without metastases were observed. The diagnosis of solid-pseudopapillary tumor of the pancreas (SPT) or Frantz’s tumor was retained. Solid-pseudo-papillary tumor of the pancreas is rare and not always suspected by the physician. The clinical and imaging patterns are not specific. Anatomopathological examination confirmed the diagnosis. The patient underwent curative surgery.
文摘BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant potential.Endoscopic ultrasound(EUS)assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis.However,there is a paucity of data regarding the imaging assessment of these lesions.AIM To determine the characteristic EUS features of SPN and define its role in preoperative assessment.METHODS This was an international,multicenter,retrospective,observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers.All cases with postoperative histology of SPN were included in the study.Data collected included clinical,biochemical,histological and EUS characteristics.RESULTS One hundred and six patients with the diagnosis of SPN were included.The mean age was 26 years(range 9 to 70 years),with female predominance(89.6%).The most frequent clinical presentation was abdominal pain(80/106;75.5%).The mean diameter of the lesion was 53.7 mm(range 15 to 130 mm),with the slight predominant location in the head of the pancreas(44/106;41.5%).The majority of lesions presented with solid imaging features(59/106;55.7%)although 33.0%(35/106)had mixed solid/cystic characteristics and 11.3%(12/106)had cystic morphology.Calcification was observed in only 4(3.8%)cases.Main pancreatic duct dilation was uncommon,evident in only 2 cases(1.9%),whilst common bile duct dilation was observed in 5(11.3%)cases.One patient demonstrated a double duct sign at presentation.Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern.EUS guided biopsy was performed using three different types of needles:Fine needle aspiration(67/106;63.2%),fine needle biopsy(37/106;34.9%),and Sonar Trucut(2/106;1.9%).The diagnosis was conclusive in 103(97.2%)cases.Ninety-seven patients were treated surgically(91.5%)and the post-surgical SPN diagnosis was confirmed in all cases.During the 2-year follow-up period,no recurrence was observed.CONCLUSION SPN presented primarily as a solid lesion on endosonographic assessment.The lesion tended to be located in the head or body of the pancreas.There was no consistent characteristic pattern apparent on either elastography or Doppler assessment.Similarly SPN did not frequently cause stricture of the pancreatic duct or common bile duct.Importantly,we confirmed that EUS-guided biopsy was an efficient and safe diagnostic tool.The needle type used does not appear to have a significant impact on the diagnostic yield.Overall SPN remains a challenging diagnosis based on EUS imaging with no pathognomonic features.EUS guided biopsy remains the gold standard in establishing the diagnosis.
基金Supported by Special Fund of Ministry of Health for Medical Research in the Public Interest,No.201202007
文摘AIM:To investigate the clinical characteristics,surgical strategies and prognosis of solid pseudopapillary tumors(SPTs)of the pancreas in male patients.METHODS:From July 2003 to March 2013,116 patients were diagnosed with SPT of the pancreas in our institution.Of these patients,16 were male.The patients were divided into two groups based on gender:female(group 1)and male(group 2).The groups were compared with regard to demographic characteristics,clinical presentations,surgical strategies,complications and follow-up outcomes.RESULTS:Male patients were older than female patients(43.1±12.3 years vs 33.1±11.5 years,P=0.04).Tumor size,location,and symptoms were comparable between the two groups.All patients,with the exception of one,underwent complete surgical resection.The patients were regularly followed up.Themean follow-up period was 58 mo.Two female patients(1.7%)developed tumor recurrence or metastases and required a second resection,and two female patients(1.7%)died during the follow-up period.CONCLUSION:Male patients with SPT of the pancreas are older than female patients.There are no significant differences between male and female patients regarding surgical strategies and prognosis.
文摘BACKGROUND 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.AIM To report a case series with SPN and analyzing clinical,surgical,anatomopathological characteristics,as well as the prognosis and review of literature.METHODS 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.RESULTS 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.CONCLUSION The tumors had a benign,indolent and histopathological behavior compatible with the literature.Curative surgery is recommended in all cases.
文摘Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic SPTs.Data sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)standards.Primary endpoints were to analyze treatments and oncological outcomes.Results:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion criteria.Overall,1384 patients underwent pancreatic surgery.Mean age was 30 years and 1181 patients(85.3%)were female.The most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 years.Conclusions:Pancreatic SPTs are rare,and predominantly affect young women with unclear pathogenesis.Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.
基金supported by the Industrial Strategic Technology development program,10048964the Ministry of Trade,Industry&Energy(MI,Korea)
文摘We have optimized the input pulse width and injection time to achieve the highest possible output pulse energy in a double-pass laser amplifier using two Nd:YAG rods. For this purpose, we have extended the Frantz–Nodvik equation by simultaneously including both spontaneous emission and pump energy variation. The effective pump energy of the flash lamp was 8.84 J for each gain medium. The energy of 1 J could be amplified to an output energy of 12.17 J with the maximum achieved extraction efficiency of 63.18% when an input pulse having a pulse width of 168 μs is sent 10 μs after the absorbed pump energy becomes the maximum value.
