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Pancreatic surgery for tumors in children and adolescents

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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.

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Author information

Authors and Affiliations

  1. Division of Pediatric Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA

    Maria G. Sacco Casamassima, Colin D. Gause, Seth D. Goldstein, Jeffrey R. Lukish & David J. Hackam

  2. Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Fizan Abdullah

  3. Division of Pediatric Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA

    Avner Meoded

  4. Department of Surgery, The Sol Goldman Pancreatic Research Center, The Johns Hopkins School of Medicine, Baltimore, MD, USA

    Christopher L. Wolfgang & John Cameron

  5. Department of Pathology, The Sol Goldman Pancreatic Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ralph H. Hruban

  6. Department of Surgery, Johns Hopkins All Children’s Hospital, 601 5th Street South, Suite 501, Saint Petersburg, FL, 33701, USA

    Paul M. Colombani

Authors
  1. Maria G. Sacco Casamassima
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  2. Colin D. Gause
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  3. Seth D. Goldstein
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  4. Fizan Abdullah
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  5. Avner Meoded
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  6. Jeffrey R. Lukish
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  7. Christopher L. Wolfgang
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  8. John Cameron
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  9. David J. Hackam
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  10. Ralph H. Hruban
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  11. Paul M. Colombani
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Corresponding author

Correspondence to Paul M. Colombani.

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Funding

This study was supported by the NIH Specialized Programs of Research Excellence P50-CA062924.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Sacco Casamassima, M.G., Gause, C.D., Goldstein, S.D. et al. Pancreatic surgery for tumors in children and adolescents. Pediatr Surg Int 32, 779–788 (2016). https://doi.org/10.1007/s00383-016-3925-y

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  • DOI: https://doi.org/10.1007/s00383-016-3925-y

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