Surgery for Solid Pseudopapillary Neoplasm – 13 years’ Experience at Nepalese Tertiary Center

Background: Solid pseudopapillary neoplasms (SPN) are rare, relatively indolent tumors with potential malignant behavior. The incidence of these tumors is increasing due to the widespread use of cross-sectional imaging. Surgery remains the mainstay of treatment and the only curative option.The study aimed to analyze the clinicopathological details, surgical management and short- & long- term outcomes of operated cases of SPN. Methods: : This is a retrospective review of diagnosed SPNs confirmed histopathologically after surgical resections at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from 2006 November to 2019 January. Patient’s clinical details, surgical procedures, perioperative outcomes and follow-up were recorded. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Results: : Over 13 y ears, a total of 15 cases with a median age of 22 years (11-52) had female predominance (14). Five cases were diagnosed incidentally while pain abdomen (5) was the most common presentation followed by lump (4). Locations of tumor were head (4), uncinate process (2), neck (2), body (4) and tail (3). Pancreaticoduodenectomies were performed in 4 cases, enucleation (3), central pancreatectomies (4), distal pancreatectomy (1) and distal pancreatico-splenectomies (3). Margins were negative in all cases with a median tumor size of 6 cm (2.5 -18). Postoperatively, 20% developed major complications with Clavien-Dindo (grade III & above) out of which 1 patient (6.7%) had mortality. The median hospital stay was 7 days (4-16). One patient was lost to follow-up while the remaining had a median follow-up of 72 months (38 months – 150 months) and revealed no issues. No recurrences were noted. Conclusion: SPNs are low-grade tumors with a good prognosis. Complete surgical resection is the treatment of choice, with excellent survival.