CC BY 4.0 · European J Pediatr Surg Rep 2019; 07(01): e58-e62
DOI: 10.1055/s-0039-1693999
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Distal Pancreatectomy of a Solid Pseudopapillary Tumor (SPT) Achieves Long-Term Oncologic Safety and Multiorgan Preservation

Ahmed ElHaddad
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
2  Department of Pediatric Surgery, Section of Pediatric Surgery, Tanta University, Tanta, Egypt
,
Paolo Gasparella
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
,
Christoph Castellani
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
,
Georg Singer
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
,
Erich Sorantin
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
,
Klara Zach
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
,
Holger Till
1  Department of Paediatric and Adolescent Surgery, Medical University Graz, Graz, Austria
› Author Affiliations
Further Information

Publication History

10 January 2019

18 June 2019

Publication Date:
21 August 2019 (online)

  

Abstract

The oncological safety of a laparoscopic approach for solid pseudopapillary tumors (SPTs) of the pancreas remains a matter of debate. We present the long-term follow-up of an adolescent girl with an SPT in the pancreatic tail. A multimodality workup including magnetic resonance imaging (MRI) revealed a complex, spherical mass of 4.4 cm × 3.6 cm × 4 cm most likely located in the pancreatic tail. All routine laboratory investigations and tumor markers were within normal limits (alpha fetoprotein [AFP], cancer antigen 125 [CA125], CA 19–9, carcinoembryonic antigen [CEA], adrenocorticotropic hormone [ACTH]). Diagnostic laparoscopy was performed to verify the origin of the tumor in the pancreatic tail. In a three-port technique the tumor was mobilized of the splenic vessels until a distal pancreatectomy could be completed. Histopathological examination confirmed the complete resection of a low-grade malignant SPT. The postoperative course was unremarkable. Regular pediatric oncological follow-up examinations for 3 years, including MRI every 6 months, ruled out recurrence and confirmed preservation of splenic and pancreatic functions. While data about the technical feasibility of a laparoscopic approach to pancreatic SPT are already available, this pediatric case report adds a long-term oncological and functional success to the available literature.