Solid and Papillary Neoplasm of the Pancreas: Emphasis on Surgical Treatment

Six Chinese females with solid and papillary neoplasms of the pancreas underwent surgery. Mean age was 26 years. The most common clinical sign was a large palpable abdominal mass. One patient presented with shock and acute onset of abdominal pain with positive peritoneal signs due to rupture of the tumor. The surgical procedures included Whipple's operation in one patient with a tumor at the head of pancreas, a 75% distal pancreatectomy in two patients with tumor of the body or tail of the pancreas, a partial pancreatectomy and pancreaticogastrostomy in one patient with a tumor at the neck and body of the pancreas, total excision in one patient with a tumor of the body of the pancreas, and a Roux-en-Y cystojejunostomy in one patient with a huge unresectable tumor of the head and body of the pancreas. During the follow-up period of from 40 to 83 months, four patients had survived and two had died of causes unrelated to the tumor or surgical procedures. It is important to consider this tumor in the differential diagnosis of a pancreatic mass, especially in young women with long histories of epigastric masses. Resection is the treatment of choice when the tumor is resectable. For unresectable tumors, a bypass procedure might be an alternative.