Diagnosis and treatment of patients with solid pseudopapillary neoplasms

Aim. To present our experience in treating patients with solid pseudopapillary tumors of the pancreas from 2007 to 2024. Material and methods. Data from 66 patients with confirmed solid pseudopapillary neoplasms were analyzed. Results. Symptoms were observed in 35 patients (53 %). According to CT and MRI findings, the preoperative diagnosis was unambiguous in 38 patients (57.5 %). All patients underwent surgery. Distal pancreatectomy was performed in 38 patients (57.6 %), pancreatoduodenectomy in 11 patients (16.7 %), enucleation in 13 patients (19.7 %), and medial resection in four patients (6.1 %). Open surgeries occurred in 36 cases (54.5 %), while laparoscopic and robotic surgeries occurred in 30 cases (45.4 %). Complications developed in 23 patients (34.8 %); one patient died (1.5 %). Histological examination revealed a pseudocapsule in 64.4 % of cases, parenchymal invasion in 25.4 %, and peripancreatic tissue invasion in 23.7 %. Lymphovascular invasion was present in 5.1 % of cases. There was no perineural invasion or lymph node metastasis. One patient was found to have liver metastases during diagnosis. Long-term outcomes were monitored in 57 patients (89 %); the mean follow-up period was 74.8 months (6–207 months). Only the patient with metastases experienced disease progression and died after 36 months. The five- and ten-year overall survival rates were 93.3 %. The five-year recurrence-free survival rate was 96.6 %, and the ten-year recurrence-free survival rate was 92.9 %. Conclusion. Solid pseudopapillary neoplasms of the pancreas are rare conditions that are becoming more frequently diagnosed. Timely surgical treatment yields favorable short- and long-term outcomes.