Pancreatic surgery for tumors in children and adolescents

Maria G. Sacco Casamassima, Colin D. Gause, Seth D. Goldstein, Fizan Abdullah, Avner Meoded, Jeffrey R. Lukish, Christopher L. Wolfgang, John Cameron, David J. Hackam, Ralph H. Hruban, Paul M. Colombani

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Purpose Pancreatic neoplasms are uncommon in children. This study sought to analyze the clinical and pathological features of surgically resected pancreatic tumors in children and discuss management strategies. Methods We conducted a retrospective review of patients ≤21 years with pancreatic neoplasms who underwent surgery at a single institution between 1995 and 2015. Results Nineteen patients were identified with a median age at operation of 16.6 years (IQR 13.5–18.9). The most common histology was solid pseudopapillary neoplasm (SPN) (n = 13), followed by pancreatic neuroendocrine tumor (n = 3), serous cystadenoma (n = 2) and pancreatoblastoma (n = 1). Operative procedures included formal pancreatectomy (n = 17), enucleation (n = 1) and central pancreatectomy (n = 1). SPNs were noninvasive in all but one case with perineural, vascular and lymph node involvement. Seventeen patients (89.5 %) are currently alive and disease free at a median follow-up of 5.7 (IQR 3.7–10.9) years. Two patients died: one with metastatic insulinoma and another with SPN who developed peritoneal carcinomatosis secondary to a concurrent rectal adenocarcinoma. Conclusions Pediatric pancreatic tumors are a heterogeneous group of neoplastic lesions for which surgery can be curative. SPN is the most common histology, is characterized by low malignant potential and in selected cases can be safely and effectively treated with a tissue-sparing resection and minimally invasive approach.

Original languageEnglish (US)
Pages (from-to)779-788
Number of pages10
JournalPediatric Surgery International
Volume32
Issue number8
DOIs
Publication statusPublished - Jan 1 2016

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Keywords

  • Children
  • Pancreatic neoplasm
  • Pancreatic neuroendocrine tumor
  • Pancreatoblastoma
  • Pediatric
  • Solid pseudopapillary tumor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Sacco Casamassima, M. G., Gause, C. D., Goldstein, S. D., Abdullah, F., Meoded, A., Lukish, J. R., ... Colombani, P. M. (2016). Pancreatic surgery for tumors in children and adolescents. Pediatric Surgery International, 32(8), 779-788. https://doi.org/10.1007/s00383-016-3925-y