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Erschienen in: Pediatric Surgery International 9/2015

01.09.2015 | Original Article

Pancreatic tumours in children: diagnosis, treatment and outcome

verfasst von: Omar Nasher, Nigel J. Hall, Neil J. Sebire, Paolo de Coppi, Agostino Pierro

Erschienen in: Pediatric Surgery International | Ausgabe 9/2015

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Abstract

Purpose

Pancreatic tumours in children are exceedingly rare and as a result constitute a diagnostic and therapeutic challenge to paediatric surgeons. We reviewed our experience with these rare entities.

Methods

Retrospective single institution study on all paediatric pancreatic tumours over a period of 38 years (1973–2011) and literature review. We recorded data relating to the clinical features at presentation, diagnostic evaluation, treatment and outcome.

Results

Fourteen patients were identified (eight male). The most common symptoms at presentation were abdominal pain, anorexia and vomiting. Two cases were discovered incidentally. There were 12 primary and 2 metastatic tumours. Tumour types were solid pseudopapillary neoplasm (n = 6), insulinoma (n = 3), pancreatoblastoma (n = 1), congenital pancreatic cyst (n = 1), Burkitt lymphoma of the pancreas (n = 1) and metastatic lesions of other primary tumours (n = 2). Twelve were treated with surgical resection including 2 laparoscopically. Post-surgical complications included acute pancreatitis (n = 2) and pancreatic pseudocyst (n = 2). There was one death from a metastatic tumour and treatment is ongoing in one patient. The remainder has survived.

Conclusion

Paediatric pancreatic tumours are rare entities and are usually benign. Clinical symptoms are often non-specific and presentation may be late due to tumour inactivity in case of endocrine neoplasms. For most tumours, surgical resection is the optimal treatment which may be successfully performed laparoscopically when the lesion is in the body or tail of the pancreas. Long-term outcome is generally good.
Literatur
3.
Zurück zum Zitat Yu DC, Kozakewich HP, Perez-Atayde AR, Shamberger RC, Weldon CB (2009) Childhood pancreatic tumors: a single institution experience. J Pediatr Surg 44:2267–2272CrossRefPubMed Yu DC, Kozakewich HP, Perez-Atayde AR, Shamberger RC, Weldon CB (2009) Childhood pancreatic tumors: a single institution experience. J Pediatr Surg 44:2267–2272CrossRefPubMed
4.
Zurück zum Zitat Walker WA, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR (2004) Pediatric gastrointestinal disease: pathophysiology, diagnosis, management, 4th edn. PMPH, USA, pp 1571–1580 Walker WA, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR (2004) Pediatric gastrointestinal disease: pathophysiology, diagnosis, management, 4th edn. PMPH, USA, pp 1571–1580
5.
Zurück zum Zitat Coleman KM, Doherty MC, Bigler SA (2003) Solid-pseudopapillary tumor of the pancreas. Radiographics 23:1644–1648CrossRefPubMed Coleman KM, Doherty MC, Bigler SA (2003) Solid-pseudopapillary tumor of the pancreas. Radiographics 23:1644–1648CrossRefPubMed
6.
Zurück zum Zitat Kloppel G, Solcia E, Longnecker DS, Capella C, Sobin LH (1996) World Health Organization: institutional histological classification of tumours—histological typing of tumours of the exocrine pancreas, 2nd edn. Springer-Verlag, GermanyCrossRef Kloppel G, Solcia E, Longnecker DS, Capella C, Sobin LH (1996) World Health Organization: institutional histological classification of tumours—histological typing of tumours of the exocrine pancreas, 2nd edn. Springer-Verlag, GermanyCrossRef
7.
Zurück zum Zitat Rebhandl W, Felberbauer FX, Puig S, Paya K, Hochschorner S, Barlan M, Horcher E (2001) Solid-pseudopapillary tumor of the pancreas (frantz tumor) in children: report of four cases and review of the literature. J Surg Oncol 76:289–296CrossRefPubMed Rebhandl W, Felberbauer FX, Puig S, Paya K, Hochschorner S, Barlan M, Horcher E (2001) Solid-pseudopapillary tumor of the pancreas (frantz tumor) in children: report of four cases and review of the literature. J Surg Oncol 76:289–296CrossRefPubMed
8.
Zurück zum Zitat Hachiyaa M, Hachiyaa Y, Mitsuia K, Tsukimoto I, Watanabe K, Fujisawa T (2003) Solid, cystic and vanishing tumors of the pancreas. J Clin Imag 27:106–108CrossRef Hachiyaa M, Hachiyaa Y, Mitsuia K, Tsukimoto I, Watanabe K, Fujisawa T (2003) Solid, cystic and vanishing tumors of the pancreas. J Clin Imag 27:106–108CrossRef
9.
Zurück zum Zitat Grosfeld JL, Vane DW, Rescorla FJ, McGuire W, West KW (1990) Pancreatic tumors in childhood: analysis of 13 cases. J Pediatr Surg 25:1057–1062CrossRefPubMed Grosfeld JL, Vane DW, Rescorla FJ, McGuire W, West KW (1990) Pancreatic tumors in childhood: analysis of 13 cases. J Pediatr Surg 25:1057–1062CrossRefPubMed
10.
11.
Zurück zum Zitat Morgan ER, Perryman JH, Reynolds M, Gonzalez-Crussi FJ (1996) Pancreatic blastomatous tumor in a child responding to therapy used for hepatoblastoma: case report and review of the literature. Med Pediatr Oncol 26:284–292CrossRefPubMed Morgan ER, Perryman JH, Reynolds M, Gonzalez-Crussi FJ (1996) Pancreatic blastomatous tumor in a child responding to therapy used for hepatoblastoma: case report and review of the literature. Med Pediatr Oncol 26:284–292CrossRefPubMed
12.
Zurück zum Zitat Drut R, Jones MC (1988) Congenital Pancreatoblastoma in Wiedemann-Beckwith syndrome: an emerging association. Pediatr Path 8:331–339CrossRef Drut R, Jones MC (1988) Congenital Pancreatoblastoma in Wiedemann-Beckwith syndrome: an emerging association. Pediatr Path 8:331–339CrossRef
13.
Zurück zum Zitat Rack KA, Delabesse E, Radford-Weiss I, Bourquelot P, Le Guyader G, Vekemans M, Macintyre EA (1998) Simultaneous detection of MYC, BVR1, and PVT1 translocations in lymphoid malignancies by fluorescence in situ hybridization. Genes Chromosomes Cancer 23:220–226CrossRefPubMed Rack KA, Delabesse E, Radford-Weiss I, Bourquelot P, Le Guyader G, Vekemans M, Macintyre EA (1998) Simultaneous detection of MYC, BVR1, and PVT1 translocations in lymphoid malignancies by fluorescence in situ hybridization. Genes Chromosomes Cancer 23:220–226CrossRefPubMed
14.
Zurück zum Zitat Sağlam M, Yılmaz MI, Mas MR, Taşçi I, Ors F, Sönmez A, Deveci S (2009) A case of pancreatic Burkitt lymphoma: radiological findings. Diagn Interv Radiol 15:39–42PubMed Sağlam M, Yılmaz MI, Mas MR, Taşçi I, Ors F, Sönmez A, Deveci S (2009) A case of pancreatic Burkitt lymphoma: radiological findings. Diagn Interv Radiol 15:39–42PubMed
15.
Zurück zum Zitat Kazez A, Akpolat N, Kocakoç E, Parmaksiz ME, Köseoğullari AA (2006) Congenital true pancreatic cyst: a rare case. Diagn Interv Radiol 12:31–33PubMed Kazez A, Akpolat N, Kocakoç E, Parmaksiz ME, Köseoğullari AA (2006) Congenital true pancreatic cyst: a rare case. Diagn Interv Radiol 12:31–33PubMed
16.
Zurück zum Zitat McPherson TC, Heersma HS (1948) Diagnosis and treatment of pancreatic cysts in children with report of a case. J Pediatrics 33:213–218CrossRef McPherson TC, Heersma HS (1948) Diagnosis and treatment of pancreatic cysts in children with report of a case. J Pediatrics 33:213–218CrossRef
17.
18.
Zurück zum Zitat Freelove R, Walling AD (2006) Pancreatic cancer: diagnosis and management. Am Fam Physician 73:485–492PubMed Freelove R, Walling AD (2006) Pancreatic cancer: diagnosis and management. Am Fam Physician 73:485–492PubMed
19.
Zurück zum Zitat Lo CY, Tama PKH (2003) Laparoscopic pancreatic resection of an insulinoma in a child. Asian J Surg 26:43–45CrossRefPubMed Lo CY, Tama PKH (2003) Laparoscopic pancreatic resection of an insulinoma in a child. Asian J Surg 26:43–45CrossRefPubMed
20.
Zurück zum Zitat Sokolov YY, Stonogin SV, Donskoy DV, Povarnin OY, Vilesov AV (2009) Laparoscopic pancreatic resections for solid pseudopapillary tumor in children. Eur J Pediatr Surg 19:399–401CrossRefPubMed Sokolov YY, Stonogin SV, Donskoy DV, Povarnin OY, Vilesov AV (2009) Laparoscopic pancreatic resections for solid pseudopapillary tumor in children. Eur J Pediatr Surg 19:399–401CrossRefPubMed
21.
Zurück zum Zitat Horiguchi A, Miyakawa S, Ishihara S, Ito M, Asano Y, Furusawa K, Shimizu T, Yamamoto T (2010) Surgical design and outcome of duodenum-preserving pancreatic head resection for benign or low-grade malignant tumors. J Hepatobiliary Pancreat Sci 17:792–797CrossRefPubMed Horiguchi A, Miyakawa S, Ishihara S, Ito M, Asano Y, Furusawa K, Shimizu T, Yamamoto T (2010) Surgical design and outcome of duodenum-preserving pancreatic head resection for benign or low-grade malignant tumors. J Hepatobiliary Pancreat Sci 17:792–797CrossRefPubMed
22.
Zurück zum Zitat Resende V, Azevedo PH, Lima Ldo P, Portela AR, Sanches MD, Pedrosa MS (2014) Duodenum-preserving pancreatic head resection in solid pseudopapillary neoplasm-report of a case. Int J Surg Case Rep 5:567–570PubMedCentralCrossRefPubMed Resende V, Azevedo PH, Lima Ldo P, Portela AR, Sanches MD, Pedrosa MS (2014) Duodenum-preserving pancreatic head resection in solid pseudopapillary neoplasm-report of a case. Int J Surg Case Rep 5:567–570PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Zampieri N, Schiavo N, Capelli P, Scarpa A, Bassi C, Camoglio FS (2011) Pseudopapillary tumor in pediatric age: clinical and surgical management. Pediatr Surg Int 27:1271–1275CrossRefPubMed Zampieri N, Schiavo N, Capelli P, Scarpa A, Bassi C, Camoglio FS (2011) Pseudopapillary tumor in pediatric age: clinical and surgical management. Pediatr Surg Int 27:1271–1275CrossRefPubMed
24.
Zurück zum Zitat Showaltera SL, Hagera E, Yeo CJ (2008) Metastatic disease to the pancreas and spleen. Semin Oncol 35:160–171CrossRef Showaltera SL, Hagera E, Yeo CJ (2008) Metastatic disease to the pancreas and spleen. Semin Oncol 35:160–171CrossRef
25.
Zurück zum Zitat Perez EA, Gutierrez JC, Koniaris LG, Neville HL, Thompson WR, Sola JE (2008) Malignant pancreatic tumors: incidence and outcome in 58 pediatric patients. J Pediatr Surg 44:197–203CrossRef Perez EA, Gutierrez JC, Koniaris LG, Neville HL, Thompson WR, Sola JE (2008) Malignant pancreatic tumors: incidence and outcome in 58 pediatric patients. J Pediatr Surg 44:197–203CrossRef
Metadaten
Titel
Pancreatic tumours in children: diagnosis, treatment and outcome
verfasst von
Omar Nasher
Nigel J. Hall
Neil J. Sebire
Paolo de Coppi
Agostino Pierro
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 9/2015
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-015-3727-7

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