Solid pseudopapillary neoplasms (SPN) of the pancreas: Findings of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)

Background/aim: This study investigated the clinicopathological features, FDG-PET findings and surgical management of solid pseudopapillary neoplasms (SPN). Methods: Seven patients who underwent surgery for pathologically confirmed SPN from 2004 to2012 at Department of Gastroenterological Surgery, Kagawa University, Japan were reviewed. Results: Seven patients were women and their mean age was 30 years. Four patients were asymptomatic, and the average tumor diameter was 31.1mm. The CT imaging characteristics were combined solid and cystic components (29 %), calcification (71%), and location in the pancreatic head (57%). All patients received FDG-PET study. Intra-tumor FDG uptake by PET was found in 5 patients (71%). The mean SUVmax in patients with positive FDG uptake was 3.89. Endoscopic ultrasonography (EUS) diagnosed SPN preoperatively in 5 of 5 patients who received EUS. All patients underwent surgical exploration, i.e., pancreaticoduodenectomy in 4 patients, middle pancreatectomy in 2 and distal pancreatectomy in 1. There was no inhospital death. Pathologic study revealed perineural invasion in 3 patients, lymphatic invasion in 1, vascular invasion in 1. There was no lymph node metastasis. All patients were alive without recurrence at a median followup of 43 months. Conclusions: SPN can be treated by complete tumor resection. Although FDG uptake is found frequently, relationwith pathologic features and malignancy is not clear.