Solid pseudopapillary epithelial neoplasm of the pancreas: an audit of 29 cases operated in a tertiary Indian centre

Abstract

Background Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is an indolent tumor of rare occurrence seen predominantly in young females in the 2nd to 4th decade. These tumors tend to grow large, producing a mass effect, or may show local invasiveness.

Method This is a retrospective analysis of a prospectively maintained database of SPEN cases operated at a tertiary care hospital in India from 2011-2023.

Results The cohort consisted of 29 patients with a male: female ratio of 1:8.6, and a median age of 24 years. The majority of the lesions were in the body and tail of the pancreas (65.5%). Mean tumor diameter was 6.1±1.9 cm. Pancreatic resection (9 distal pancreatectomies, 7 Whipple’spancreatic oduodenectomies, 2 central pancreatectomies) was undertaken in the majority of cases (62.1%), while 11 patients (37.9%) underwent enucleation. Additional resections included splenectomy (n=4), segmental colonic resection (n=2), and 1 non-anatomical liver wedge resection for solitary liver metastasis. Mean operative time and blood loss were 222.1±106.1 min and 115.5±85.9 mL, respectively. Minor complications were seen in 7 (24.1%) patients, while 1 patient had a major complication. At a median follow up of 37 months, 28 (96.6%) patients were alive, 1 of whom had local recurrence.

Conclusions SPEN represents an indolent, low-grade malignant tumor that is reasonably diagnosed preoperatively by cross-sectional imaging. The majority of cases are cured by surgical resection, the extent of which is dictated by the location of the tumor and its relation to surrounding structures. Excellent outcomes, both short- and long-term, can be achieved.

Keywords Solid pseudopapillary epithelial neoplasm, pancreatic resection, enucleation

Ann Gastroenterol 2026; 39 (4): 464-470