[Solid pseudopapilar pancreatic tumors: report of 7 cases and review of the literature]. / Tumores sólidos pseudopapilares de páncreas: reporte de 7 casos y revisión de la literatura.

INTRODUCTION: The cystic tumors of the pancreas represent an uncommon entity and the less frequent type among them is the solid pseudopapillary tumor of the pancreas. Its main difference lies in the fact that this type of tumor is more frequent in young patients. Solid pseudopapillary tumors are generally tumors of large size and the majority of them have a benign behavior. MATERIAL AND METHOD: During a period of three years, seven patients with this neoplasia underwent surgery. Six patients (86%) were females and just one was a male, all of them between the ages of 11 and 37. None of these cases showed metastasis and there were no signs of malignancy reported in the pathological anatomy. The average tumor size was 8 cm and the head of the pancreas was the most frequent location (57%). Of the resections performed in these patients, three were middle pancreatectomies, two were distal pancreatectomies one was a duodenopancreatectomy and one was duodenum preserving head resection of the pancreas. DISCUSSION: The solid pseudopapillary tumors are uncommon tumors which are generally benign or premalignant neoplasias. Nevertheless, 9% of them can behave like carcinomas; therefore, these tumors should not be ignored.

Tumores sólidos Pseudopapilares de páncreas: reporte de 7 casos y revisión de la literatura / Solid Pseudopapillary pancreatic tumors: report of 7 cases and review of the Literature

Introducción: Los tumores quísticos del páncreas representan una entidad poco común, la variedad menos frecuente dentro de estos tumores es el tumor sólido pseudopapilar del páncreas. Su diferencia principal radica en que se presenta más frecuente en pacientes jóvenes. Son tumores generalmente de gran tamaño siendo la mayoría de ellos de comportamiento benigno. Material y método: Durante un periodo de tres años se han operado a 7 pacientes con esta neoplasia. Seis pacientes (86) fueron de sexo femenino y uno solo fue de sexo masculino, las edades fluctuaron desde los 11 a los 37 años, en ningún caso se encontraron metástasis o en la anatomía patológica se reportaron signos de malignidad. El promedio del tamaño tumoral fue de 8 cm y la localización más frecuente fue la cabeza de páncreas (57), realizándose tres pancreatectomias medias, dos pancreatectomias distales una duodenopancreatectomia, y una resección de cabeza de páncreas con preservación de duodeno. Discusión: Los tumores sólidos pseudopapilares son poco frecuentes generalmente se tratan de neoplasias benignas o pre malignas pero en un 9 pueden comportarse como carcinoma por lo cual estos tumores no pueden ser ignorados.

Introduction: The cystic tumors of the pancreas represent an uncommon entity and the less frequent type among them is the solid pseudopapillary tumor of the pancreas. Its main difference lies in the fact that this type of tumor is more frequent in young patients. Solidpseudopapillary tumors are generally tumors of large size and the majority of them have a benign behavior. MATERIAL AND METHOD: During a period of three years, seven patients with this neoplasia underwent surgery. Six patients (86 per cent) were females and just one was a male, all of them between the ages of 11 and 37. None of these cases showed metastasis and there were no signs of malignancy reported in the pathological anatomy. The average tumor size was 8 cm and the head of the pancreas was the most frequent location (57 per cent). Of the resections performed in these patients, three were middlepancreatectomies, two were distal pancreatectomies one was a duodenopancreatectomy and one was duodenum preserving head resection of the pancreas. DISCUSSION: The solid pseudopapillary tumors are uncommon tumors which are generally benign orpremalignant neoplasias. Nevertheless, 9% of them can behave like carcinomas; therefore, these tumors should not be ignored.

[Surgical treatment of giant serous cystadenoma of pancreas: report of two cases]. / Tratamiento quirúrgico de los cistoadenoma serosos gigantes del páncreas reporte de dos casos.

INTRODUCTION: The cystic tumor of the pancreas is a relatively uncommon entity. There are different types of pancreatic cystic tumors and they all exhibit different degrees of malignancy. These tumors represent 1% of all primary pancreatic tumors and only 15% of the cystic lesions. The serous cystadenomas (SCA) are mostly benign lesions with an average size of 4 cm; nevertheless, in some rare cases these are giant lesions, generally larger than 15 cm. Sometimes these tumors produce a symptomatology caused by the compression of neighboring structures, therefore they are generally operable. MATERIAL AND METHOD: During the period from June 2004 to June 2005, the 3A II unit of the Edgardo Rebagliati Martins Hospital operated on two cases of giant serous cystadenomas of the pancreas, one located in the tail of the pancreas and the other in the head of the pancreas, with an average size of 16 cm. DISCUSSION: The giant SCAs of the pancreas are rarely seen lesions that, according to different authors, are usually larger than 10 to 15 cm. in diameter. These lesions do not represent a diagnosis problem and are generally operable since they produce a symptomatology by compression. The surgical resection can be complicated due to their large size and to the considerable neovascularization.

Tratamiento quirúrgico de los cistoadenoma serosos gigantes del páncreas reporte de dos casos / Surgical treatment of the giant serous cystoadenoma of the pancreas reports of two cases

Introducción: Los tumores quísticos del páncreas son una entidad poco común que reúnen a distintas variedades. Las cuales presentan diferentes grados de malignidad. Estos representan el 1 por ciento de todos los tumores primarios del páncreas y solo el 15 por ciento de las lesiones quísticas. Los cistoadenomas serosos (SCA) son lesiones casi siempre benignas con un tamaño promedio de 4 cm sin embargo en muy raros casos existen lesiones gigantes generalmente mayores de 15 cm, estos tumores algunas veces producen una sintomatología causada por la comprensión de estructuras vecinas por lo que generalmente son quirúrgicos. Material y método: Durante el periodo comprendido entre Junio del 2004 a Junio del 2005 se operaron en el servicio 3A II del Hospital Edgardo Rebagliati Martins dos casos de cistoadenomas serosos gigantes del páncreas uno localizado en la cola del páncreas y otro en la cabeza con un tamaño promedio de 16 cm. Discusión: Los SCA gigantes del páncreas son lesiones muy poco frecuentes generalmente mayores de 10 a 15 cm. de diámetro de acuerdo a los diferentes autores, estas lesiones no presentan un problema diagnóstico, siendo generalmente quirúrgicas ya que producen sintomatología por comprensión. La resección quirúrgica puede ser complicada debido al gran tamaño y a la neovascularización importante que presentan.

Introduction: The cystic tumor of the pancreas is a relatively uncommon entity. There are different types of pancreatic cystic tumors and they all exhibit different degrees of malignancy.These tumors represent 1 per cent of all primary pancreatic tumors and only 15 per cent of the cystic lesions. The serous cystadenomas (SCA) are mostly benign lesions with an average size of 4 cm; nevertheless, in some rare cases these are giant lesions, generally larger than 15 cm. Sometimes these tumors produce a symptomatology caused by the compression of neighboring structures, therefore they are generally operable.MATERIAL AND METHOD: During the period from June 2004 to June 2005, the 3A II unit of the Edgardo RebagliatiMartins Hospital operated on two cases of giant serous cystadenomas of the pancreas, one located in the tail of the pancreas and the other in the head of the pancreas, with an average size of 16 cm. DISCUSSION: The giant SCAs of the pancreas are rarely seen lesions that, according to different authors, are usually larger than 10 to 15 cm. in diameter. These lesions do not representa diagnosis problem and are generally operable since they produce a symptomatology by compression. The surgical resection can be complicated due to their large size and to the considerable neovascularization.

[Transduodenal ampullectomy: an useful alternative for the treatment of Vater's ampulla lesions. Case reports of an unfrecuent surgical technique]. / Ampulectomía transduodenal una alternativa útil para el tratamiento de las lesiones de la ampolla de Vater: reporte de casos de una técnica raramente utilizada.

The Vater's ampulla neoplasias are not very frequent lesions. The ampullectomy consists on the total resection of the Vater's ampulla and part of the duodenal wall with the later reconstruction and anastomosis of the common bile duct and the Wirsung's duct to the duodenum. The local resection of the ampulla is an alternative to the duodenopancreatectomy that has to be taken into account, especially in benign lesions as in the case of adenomas of the Vater's ampulla. Here we describe two cases one with adenoma of the Vater's ampulla, with a high degree dysplasia, who first underwent an ampullectomy and finally ended up in a duodenopancreatectomy due to the infiltration of the adenoma into the edge of section and other case of Lymphangioma of Vater's ampulla with no infiltration in the edge of section.