Is laparoscopic management suitable for solid pseudo-papillary tumors of the pancreas? |
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Authors: | P O Fais E Carricaburu S Sarnacki D Berrebi D Orbach V Baudoin Pascal de Lagausie |
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Institution: | (1) Department of Pediatric Surgery, Timone Enfants Hospital, 264 Bld Saint Pierre, 13385 Marseille Cedex 05, France;(2) Department of Pediatric Surgery, Robert Debré Hospital, Paris, France;(3) Department of Pediatric Surgery, Necker Enfants-Malades Hospital, Paris, France;(4) Department of Pathology, Robert Debré Hospital, Paris, France;(5) Institut Curie, Paris, France;(6) Department of Pediatric Nephrology, Robert Debré Hospital, Paris, France |
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Abstract: | Purpose Solid pseudo-papillary tumors (SPT) are rare pancreatic neoplasms of low-malignant potential occurring mainly in young women.
The purpose of this report is to describe our experience with laparoscopic management of these tumors with 4-year follow-up.
Methods Three children with SPT were admitted to two hospitals in Paris, France, between February 2000 and December 2006. Diagnosis
or treatment was carried out using laparoscopic techniques (biopsy and resection in one case and biopsy only in two). Long-term
follow-up data were collected.
Results All three patients presented recurrences within 3 years after resection, i.e., disseminated peritoneal recurrence in two patients
and local recurrence in one. The two patients with peritoneal recurrences were treated by surgical resection and chemotherapy.
The patient with local recurrence could not be treated due to contraindicating local factors. All three patients were alive
at the time of this writing.
Conclusion This is the first report describing long-term follow-up after laparoscopic management of SPT. All three patients developed
recurrences. These poor results contrast sharply with the low risk of local or disseminated recurrence after open laparotomy
without chemotherapy that has been considered as the treatment of choice up to now. Recurrences after laparoscopic management
may have been due to diffusion of tumor cells caused by gas insufflation especially during biopsy. Laparoscopic biopsy should
not be performed in patients presenting SPT. |
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Keywords: | Frantz's tumour Pancreas Cysto-papillary tumour Laparoscopy Child Reccurence Peritoneal carcinosis |
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