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Solid Pseudopapillary Tumor of the Pancreas (Frantz Tumor) : A Case Report

Pancreatic Pseudopapillary Tumor (PTS) or Frantz tumor is a rare tumor of the exocrine pancreas with a low grade of malignancy. It mainly occurs in young women (20 to 40 years old) with an increased frequency in the Asian population. Their prognosis remains good especially after complete excision. We report the management of a 21-year-old patient for a Frantz tumor, revealed by abdominal pain. The diagnosis is made on the histological study associated with the immunohistochemistry of the caudal spleno-pancreatectomy part.

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Japanese Journal of Gastroenterology and Hepatology
Case Report ISSN 2435-1210 Volume 6
Solid Pseudopapillary Tumor of the Pancreas (Frantz Tumor) : A Case Report
Zatir S1*
, lemoui S1
, Larkaam T1
, Bouchakour S2
, Laouisset S2
, Abdellaoui K2
, Mouloudi S3
, aidouni M4
and Adnane D1
1
Department of medical and surgical emergency, Oran University Military Hospital Algeria
2
Department of General Surgery, Algeria
3
Medical Imaging Service, Algeria
4
Department of Anapthology, Algeria
*
Corresponding author:
Zatir Soufiane,
Department of medical and surgical emergency,
Oran University Military Hospital Algeria,
E-mail : s.zatir@yahoo.com
Received: 10 Jun 2021
Accepted: 29 Jun 2021
Published: 05 Jul 2021
Copyright:
©2021 Zatir S, This is an open access article distributed under
the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and build upon your work
non-commercially.
Citation:
Zatir S. Solid Pseudopapillary Tumor of the Pancreas (Frantz
Tumor) : A Case Report.
Japanese J Gstro Hepato. 2021; V6(20): 1-3
1
Keywords:
Pancreas ; Pseudopapillary and solid tumor; Frantz;
Surgical resection
1. Abstract
Pancreatic Pseudopapillary Tumor (PTS) or Frantz tumor is a rare
tumor of the exocrine pancreas with a low grade of malignancy. It
mainly occurs in young women (20 to 40 years old) with an increased
frequency in the Asian population. Their prognosis remains good
especially after complete excision. We report the management of a
21-year-old patient for a Frantz tumor, revealed by abdominal pain.
The diagnosis is made on the histological study associated with the
immunohistochemistry of the caudal spleno-pancreatectomy part.
2. Introduction
Solid Pancreatic Pseudopapillary Tumors (TPPSP) are rare. They
represent less than 2% of pancreatic cancers. They mainly affect
young women. Their etiopathogenesis remains uncertain. They are
characterized by clinical and radiological polymorphism which makes
their diagnosis difficult. The only treatment guaranteeing prolonged
survival is surgical resection. Their prognosis is excellent. The risk of
metastases, mainly hepatic, is low (less than 15%). The risk of recur-
rence of this tumor, low, nevertheless requires long-term follow-up.
3. Observation
A 21-year-old patient, with no history, was admitted for pain in the
left hypochondrium of progressive onset, of a gravity type, without
accompanying signs. The physical examination was unremarkable.
The abdominal ultrasound showed a tissue and multi-cystic mass be-
tween the spleen and the tail of the pancreas. The abdominal CT had
concluded in a cystic mass, well limited, finely partitioned of the tail
of the pancreas, measuring 7cm (Figure 1). Surgical treatment con-
sisted of a caudal splenopancreatomy removing the cystic mass with
partial splenectomy. Morphological study and immunohistochem-
istry (positive antibodies are: anti-CD10, anti-vimentin, anti-NSE,
anti-CD56, anti-RP and anti-synaptophysin) returned in favor of
TPPSP with resection complete. The post-operative consequences
were simple.
Figure 1: CT scan
4. Discussion
The solid pseudo papillary tumor of the pancreas (TPPSP) was first
described by Frantz in 1959 [1]. It is a rare tumor that represents less
than 2% of exocrine pancreatic tumors and less than 5% of cystic
2
2021, V6(20): 1-2
pancreatic tumors [2]. It typically affects young women with an av-
erage age of 28 and a sex ratio of 10: 1 [3]. However, rare sporadic
cases in men and the elderly have also been reported. This tumor af-
fects the head, body or tail of the pancreas as well, with nevertheless
a predominance in the corporéo-caudal region (64% of cases) [4].
Rare cases of extrapancreatic localizations are also described (1%),
namely retroperitoneal, duodenal, mesocolic, hepatic [4, 5]. The cir-
cumstances of discovery are very variable and not very specific: it
may be a fortuitous discovery during an imaging examination carried
out for another reason, or during the appearance of a palpable ab-
dominal mass, or even by non-specific abdominal pain. Sometimes
the tumor, by increasing in size, causes signs of compression of the
neighboring digestive, biliary or vascular structures [6]. Complemen-
tary examinations generally show a well-encapsulated complex mass
with both solid and cystic components. The ultrasound appearance
of the tumor varies depending on the size of the cystic areas. But
in almost all cases, TPPSP presents as a well-defined cystic mass,
with regular contours little or no vascularization, with heterogeneous
content and without internal partitions [5]. Abdominal computed
tomography shows a well-defined, heterogeneous, solid and cystic
mass, which increases slightly or partially at the periphery after in-
jection of the contrast product [8]. MRI is the best way to obtain
information on bleeding within the lesion by multi-plane imaging [9].
It also makes it possible to highlight the fibrous capsule and to differ-
entiate between solid and intratumoral cystic components [10]. Data
from CT or MRI combined with age and gender should be sufficient
to indicate surgery. The only curative treatment is surgery, in which
the choice of the operative method depends on the size, the tumor
location and a possible invasion of adjacent organs. It consists of
a left pancreatectomy with preservation of the spleen if possible, a
cephalic duodeno-pancreatectomy, a partial or even total pancreatec-
tomy [17]. The resection should be extended in the event of invasion
of neighboring organs, and any nodules of peritoneal carcinoma
should be resected [20]. The existence of an invasion of the portal
or mesenteric veins should not contraindicate a curative procedure,
cases of portal or superior mesenteric resection having been report-
ed with prolonged survival [5]. Associated metastatic lesions should
be resected with an acceptable risk, and tumor recurrence should
benefit from attempted surgical excision [8]. Lymph node dissection
remains controversial. The role of adjuvant chemotherapy or radio-
therapy is debatable [8]. The onset of symptoms seems to go back 4
months ago with the appearance of pain in the left hypochondrium
motivating the patient to consult a complete abdominal ultrasound
with an abdominal CT scan (Figure 1) which revealed a mass of 9
cm long axis which sits at the level of the pancreatic tail. a pan-
creatic MRI (Figure 2) was performed which targeted a solidcystic
mass of the pancreatic tail with invasion of the splenic hilum. we
performed a left splenopancreatectomy (Figure 3), the anapathologic
piece came back in favor of a frantz tumor [11-14]. The patient has
had a good postoperative follow-up. Usually, tumor cells are labeled
with anti-CD 10, alpha-1-antitrypsin, vimentin, NSE, E-caderin and
beta-catenin antibodies. There is also an anti-progesterone antibody
labeling [15]. Positive immunostaining of tumor cells for certain en-
docrine markers can attest to some endocrine differentiation [16].
Figure 2: MRI
Figure 3: left splenopancreatectomy
5. Conclusion
Solid pseudo-papillary tumor of the pancreas is a rare tumor. Its di-
agnosis is based on radiology, in particular the abdominal CT scan
and MRI coupled with the anapathology study. Surgical treatment is
the treatment of choice for this kind of pathology.
References
1.	 Frantz VK. Atlas of tumor pathology, section VII. Washington DC:
Armed Forces Institute of Pathology; Tumors of the pancreas. 1959;
28. [fascicles 27] [Google Scholar].
2.	 Canzonieri V, Berretta M, Buonadonna A, et al. Solid pseudo-papil-
lary tumour of the pancreas. Lancet Oncol. 2003; 4: 255–6. [PubMed]
[Google Scholar].
3.	 Yu PF, Hu ZH, Wang XB, Guo JM, Cheng XD, Zhang YL et al. Solid
pseudo papillary tumor of the pancreas: a review of 553 cases in Chi-
nese literature. World J Gastroenterol. 2010; 16: 1209–14. [Article PMC
gratuit] [PubMed] [Google Scholar].
4.	 Denis MA, Frere A, Brixko C, Dresse D, Denoël A et al. Tumeur pseu-
do-papillaire pancréatique révélée par la rupture de varices oeso-gas-
triques secondaire à une cirrhose biliaire par une compression cholédo-
cienne. Gastroenterol Clin Biol. 2005; 29: 291-293. [PubMed] [Google
Scholar].
3
2021, V6(20): 1-3
5.	 Podevin J, Triau S, Mirallie E, Le Borgne J. Tumeurs pseudopapillaires
et solides du pancréas: à propos de cinq cas et revue de la littérature.
Ann Chir. 2003; 128: 543–8. [PubMed] [Google Scholar].
6.	 Wang DB, Wang QB, Chai WM, Chen KM, Deng XX. Imaging features
of solid pseudopapillary tumor of the pancreas on multi-detector row
computed tomography. World J Gastroenterol. 2009; 15:829–35. [Arti-
cle PMC gratuit] [PubMed] [Google Scholar].
7.	 Sugito K, Kusafuka T, Hoshino M, Inoue M, Ikeda T, Hagiwara N et
al. Application of radiofrequency ablation for giant solid pseudopap-
illary tumor of the pancreas. Pediatr Int. 2010; 52: e29–31. [PubMed]
[Google Scholar].
8.	 Cheng-Hong P, Dong-Feng C, Guang-Wen Z, Yang M. The solid pseu-
dopapillary tumor of pancreas: the clinical characteristics and surgical
treatment. J Surg Res. 2006; 131: 276–82. [PubMed] [Google Scholar].
9.	 Ning Guo, Quan Zhou B, Ru Chen F, Sheng Zou Q, Zhi Li H, Qing,
Jie Wang. Diagnosis and surgical treatment of solid pseudopapillary
neoplasm of the pancreas: analysis of 24 cases. Association médicale
canadienne; 2011. [Google Scholar]
10.	 Petrone MC, Arcidiacpno PG. Role of endoscopic ultrasound in the
diagnosis of custic tumors of the pancreas. Dig Liver Dis. 2008; 40:
847–53. [PubMed] [Google Scholar].
11.	 Deest G, Gauss X, kerdaron R, piquard A, Lagasse JP. Apport de
l’echoendoscopie pour le diagnostic des TPPS du pancreas. Gastroen-
terol Clin Biol. 2008; 32: 813–5. [PubMed] [Google Scholar].
12.	 Pettinato G, Di Vizio D, Manivel JC, Pambuccian SE, Somma P, Insa-
bato L et al. Solid pseudopapillary tumor of the pancreas: a neoplasm
with distinct and highly characteristic cytological features. Diagn Cyto-
pathol. 2002; 27: 325–34. [PubMed] [Google Scholar].
13.	 Zeqiang Ren, Pengbo Zhang, Xiuzhong Zhang, Bin Liu. Solid pseu-
dopapillary neoplasms of the pancreas: clinicopathologic features and
surgical treatment of 19 cases. Int J Clin Exp Pathol. 2014; 7: 6889–97.
[Article PMC gratuit] [PubMed] [Google Scholar].
14.	 Hamilton SR, Aaltonen LA. Pathology and genetics of tumours of the
digestive system. Lyon: IARC press; Solid-pseudopapillary neoplasm.
World health organization classification of tumors. 2000; 246–8. [Goo-
gle Scholar].
15.	 Kim MJ, Jang SJ, Yu E. Loss of E-cadherin and cytoplasmic-nuclear
expression of beta-catenin are the most useful immunoprofiles in the
diagnostis of solid-pseudopapillary neoplasm of the pancreas. Hum
Pathol. 2008; 39: 251–8. [PubMed] [Google Scholar].
16.	 Ayadi L, Ellouze S, Khabir A, Daoud E. La tumeur de Frantz: une
étude anatomoclinique de six cas tunisiens. Rev Med Brux. 2008; 29:
572–6. [PubMed] [Google Scholar].
17.	 Abid M, Ben Salah K, Guirat MA, Cheikhrouhou H, Khlif M, Khabir
A et al. Tumeurs pseudopapillaires et solides du pancréas: deux obser-
vations et revue de la littérature. Rev Med Interne. 2009; 30: 440–2.
[PubMed] [Google Scholar].
18.	 Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the
pancreas: review of 718 patients reported in English literature. J Am
Coll Surg. 2005; 200: 965–72. [PubMed] [Google Scholar].
19.	 Bahri I, Njim L, Khabir A, Mahmoudi H, Ghorbel A, Zakhama A et
al. Tumeur papillaire solide et kystique du pancréas. Ann Chir. 2001;
126: 899–902. [PubMed] [Google Scholar].
20.	 Guedira M, Hrora A, Raïss M, El Alaoui M, Kettani F, Tounsi A et al.
Tumeurs pseudopapillaires et solides du pancréas. J Chir. 2006; 143:
271–3. [PubMed] [Google Scholar].

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Solid Pseudopapillary Tumor of the Pancreas (Frantz Tumor) : A Case Report

  • 1. Japanese Journal of Gastroenterology and Hepatology Case Report ISSN 2435-1210 Volume 6 Solid Pseudopapillary Tumor of the Pancreas (Frantz Tumor) : A Case Report Zatir S1* , lemoui S1 , Larkaam T1 , Bouchakour S2 , Laouisset S2 , Abdellaoui K2 , Mouloudi S3 , aidouni M4 and Adnane D1 1 Department of medical and surgical emergency, Oran University Military Hospital Algeria 2 Department of General Surgery, Algeria 3 Medical Imaging Service, Algeria 4 Department of Anapthology, Algeria * Corresponding author: Zatir Soufiane, Department of medical and surgical emergency, Oran University Military Hospital Algeria, E-mail : s.zatir@yahoo.com Received: 10 Jun 2021 Accepted: 29 Jun 2021 Published: 05 Jul 2021 Copyright: ©2021 Zatir S, This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Citation: Zatir S. Solid Pseudopapillary Tumor of the Pancreas (Frantz Tumor) : A Case Report. Japanese J Gstro Hepato. 2021; V6(20): 1-3 1 Keywords: Pancreas ; Pseudopapillary and solid tumor; Frantz; Surgical resection 1. Abstract Pancreatic Pseudopapillary Tumor (PTS) or Frantz tumor is a rare tumor of the exocrine pancreas with a low grade of malignancy. It mainly occurs in young women (20 to 40 years old) with an increased frequency in the Asian population. Their prognosis remains good especially after complete excision. We report the management of a 21-year-old patient for a Frantz tumor, revealed by abdominal pain. The diagnosis is made on the histological study associated with the immunohistochemistry of the caudal spleno-pancreatectomy part. 2. Introduction Solid Pancreatic Pseudopapillary Tumors (TPPSP) are rare. They represent less than 2% of pancreatic cancers. They mainly affect young women. Their etiopathogenesis remains uncertain. They are characterized by clinical and radiological polymorphism which makes their diagnosis difficult. The only treatment guaranteeing prolonged survival is surgical resection. Their prognosis is excellent. The risk of metastases, mainly hepatic, is low (less than 15%). The risk of recur- rence of this tumor, low, nevertheless requires long-term follow-up. 3. Observation A 21-year-old patient, with no history, was admitted for pain in the left hypochondrium of progressive onset, of a gravity type, without accompanying signs. The physical examination was unremarkable. The abdominal ultrasound showed a tissue and multi-cystic mass be- tween the spleen and the tail of the pancreas. The abdominal CT had concluded in a cystic mass, well limited, finely partitioned of the tail of the pancreas, measuring 7cm (Figure 1). Surgical treatment con- sisted of a caudal splenopancreatomy removing the cystic mass with partial splenectomy. Morphological study and immunohistochem- istry (positive antibodies are: anti-CD10, anti-vimentin, anti-NSE, anti-CD56, anti-RP and anti-synaptophysin) returned in favor of TPPSP with resection complete. The post-operative consequences were simple. Figure 1: CT scan 4. Discussion The solid pseudo papillary tumor of the pancreas (TPPSP) was first described by Frantz in 1959 [1]. It is a rare tumor that represents less than 2% of exocrine pancreatic tumors and less than 5% of cystic
  • 2. 2 2021, V6(20): 1-2 pancreatic tumors [2]. It typically affects young women with an av- erage age of 28 and a sex ratio of 10: 1 [3]. However, rare sporadic cases in men and the elderly have also been reported. This tumor af- fects the head, body or tail of the pancreas as well, with nevertheless a predominance in the corporéo-caudal region (64% of cases) [4]. Rare cases of extrapancreatic localizations are also described (1%), namely retroperitoneal, duodenal, mesocolic, hepatic [4, 5]. The cir- cumstances of discovery are very variable and not very specific: it may be a fortuitous discovery during an imaging examination carried out for another reason, or during the appearance of a palpable ab- dominal mass, or even by non-specific abdominal pain. Sometimes the tumor, by increasing in size, causes signs of compression of the neighboring digestive, biliary or vascular structures [6]. Complemen- tary examinations generally show a well-encapsulated complex mass with both solid and cystic components. The ultrasound appearance of the tumor varies depending on the size of the cystic areas. But in almost all cases, TPPSP presents as a well-defined cystic mass, with regular contours little or no vascularization, with heterogeneous content and without internal partitions [5]. Abdominal computed tomography shows a well-defined, heterogeneous, solid and cystic mass, which increases slightly or partially at the periphery after in- jection of the contrast product [8]. MRI is the best way to obtain information on bleeding within the lesion by multi-plane imaging [9]. It also makes it possible to highlight the fibrous capsule and to differ- entiate between solid and intratumoral cystic components [10]. Data from CT or MRI combined with age and gender should be sufficient to indicate surgery. The only curative treatment is surgery, in which the choice of the operative method depends on the size, the tumor location and a possible invasion of adjacent organs. It consists of a left pancreatectomy with preservation of the spleen if possible, a cephalic duodeno-pancreatectomy, a partial or even total pancreatec- tomy [17]. The resection should be extended in the event of invasion of neighboring organs, and any nodules of peritoneal carcinoma should be resected [20]. The existence of an invasion of the portal or mesenteric veins should not contraindicate a curative procedure, cases of portal or superior mesenteric resection having been report- ed with prolonged survival [5]. Associated metastatic lesions should be resected with an acceptable risk, and tumor recurrence should benefit from attempted surgical excision [8]. Lymph node dissection remains controversial. The role of adjuvant chemotherapy or radio- therapy is debatable [8]. The onset of symptoms seems to go back 4 months ago with the appearance of pain in the left hypochondrium motivating the patient to consult a complete abdominal ultrasound with an abdominal CT scan (Figure 1) which revealed a mass of 9 cm long axis which sits at the level of the pancreatic tail. a pan- creatic MRI (Figure 2) was performed which targeted a solidcystic mass of the pancreatic tail with invasion of the splenic hilum. we performed a left splenopancreatectomy (Figure 3), the anapathologic piece came back in favor of a frantz tumor [11-14]. The patient has had a good postoperative follow-up. Usually, tumor cells are labeled with anti-CD 10, alpha-1-antitrypsin, vimentin, NSE, E-caderin and beta-catenin antibodies. There is also an anti-progesterone antibody labeling [15]. Positive immunostaining of tumor cells for certain en- docrine markers can attest to some endocrine differentiation [16]. Figure 2: MRI Figure 3: left splenopancreatectomy 5. Conclusion Solid pseudo-papillary tumor of the pancreas is a rare tumor. Its di- agnosis is based on radiology, in particular the abdominal CT scan and MRI coupled with the anapathology study. Surgical treatment is the treatment of choice for this kind of pathology. References 1. Frantz VK. Atlas of tumor pathology, section VII. Washington DC: Armed Forces Institute of Pathology; Tumors of the pancreas. 1959; 28. [fascicles 27] [Google Scholar]. 2. Canzonieri V, Berretta M, Buonadonna A, et al. Solid pseudo-papil- lary tumour of the pancreas. Lancet Oncol. 2003; 4: 255–6. [PubMed] [Google Scholar]. 3. Yu PF, Hu ZH, Wang XB, Guo JM, Cheng XD, Zhang YL et al. Solid pseudo papillary tumor of the pancreas: a review of 553 cases in Chi- nese literature. World J Gastroenterol. 2010; 16: 1209–14. [Article PMC gratuit] [PubMed] [Google Scholar]. 4. Denis MA, Frere A, Brixko C, Dresse D, Denoël A et al. Tumeur pseu- do-papillaire pancréatique révélée par la rupture de varices oeso-gas- triques secondaire à une cirrhose biliaire par une compression cholédo- cienne. Gastroenterol Clin Biol. 2005; 29: 291-293. [PubMed] [Google Scholar].
  • 3. 3 2021, V6(20): 1-3 5. Podevin J, Triau S, Mirallie E, Le Borgne J. Tumeurs pseudopapillaires et solides du pancréas: à propos de cinq cas et revue de la littérature. Ann Chir. 2003; 128: 543–8. [PubMed] [Google Scholar]. 6. Wang DB, Wang QB, Chai WM, Chen KM, Deng XX. Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography. World J Gastroenterol. 2009; 15:829–35. [Arti- cle PMC gratuit] [PubMed] [Google Scholar]. 7. Sugito K, Kusafuka T, Hoshino M, Inoue M, Ikeda T, Hagiwara N et al. Application of radiofrequency ablation for giant solid pseudopap- illary tumor of the pancreas. Pediatr Int. 2010; 52: e29–31. [PubMed] [Google Scholar]. 8. Cheng-Hong P, Dong-Feng C, Guang-Wen Z, Yang M. The solid pseu- dopapillary tumor of pancreas: the clinical characteristics and surgical treatment. J Surg Res. 2006; 131: 276–82. [PubMed] [Google Scholar]. 9. Ning Guo, Quan Zhou B, Ru Chen F, Sheng Zou Q, Zhi Li H, Qing, Jie Wang. Diagnosis and surgical treatment of solid pseudopapillary neoplasm of the pancreas: analysis of 24 cases. Association médicale canadienne; 2011. [Google Scholar] 10. Petrone MC, Arcidiacpno PG. Role of endoscopic ultrasound in the diagnosis of custic tumors of the pancreas. Dig Liver Dis. 2008; 40: 847–53. [PubMed] [Google Scholar]. 11. Deest G, Gauss X, kerdaron R, piquard A, Lagasse JP. Apport de l’echoendoscopie pour le diagnostic des TPPS du pancreas. Gastroen- terol Clin Biol. 2008; 32: 813–5. [PubMed] [Google Scholar]. 12. Pettinato G, Di Vizio D, Manivel JC, Pambuccian SE, Somma P, Insa- bato L et al. Solid pseudopapillary tumor of the pancreas: a neoplasm with distinct and highly characteristic cytological features. Diagn Cyto- pathol. 2002; 27: 325–34. [PubMed] [Google Scholar]. 13. Zeqiang Ren, Pengbo Zhang, Xiuzhong Zhang, Bin Liu. Solid pseu- dopapillary neoplasms of the pancreas: clinicopathologic features and surgical treatment of 19 cases. Int J Clin Exp Pathol. 2014; 7: 6889–97. [Article PMC gratuit] [PubMed] [Google Scholar]. 14. Hamilton SR, Aaltonen LA. Pathology and genetics of tumours of the digestive system. Lyon: IARC press; Solid-pseudopapillary neoplasm. World health organization classification of tumors. 2000; 246–8. [Goo- gle Scholar]. 15. Kim MJ, Jang SJ, Yu E. Loss of E-cadherin and cytoplasmic-nuclear expression of beta-catenin are the most useful immunoprofiles in the diagnostis of solid-pseudopapillary neoplasm of the pancreas. Hum Pathol. 2008; 39: 251–8. [PubMed] [Google Scholar]. 16. Ayadi L, Ellouze S, Khabir A, Daoud E. La tumeur de Frantz: une étude anatomoclinique de six cas tunisiens. Rev Med Brux. 2008; 29: 572–6. [PubMed] [Google Scholar]. 17. Abid M, Ben Salah K, Guirat MA, Cheikhrouhou H, Khlif M, Khabir A et al. Tumeurs pseudopapillaires et solides du pancréas: deux obser- vations et revue de la littérature. Rev Med Interne. 2009; 30: 440–2. [PubMed] [Google Scholar]. 18. Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. J Am Coll Surg. 2005; 200: 965–72. [PubMed] [Google Scholar]. 19. Bahri I, Njim L, Khabir A, Mahmoudi H, Ghorbel A, Zakhama A et al. Tumeur papillaire solide et kystique du pancréas. Ann Chir. 2001; 126: 899–902. [PubMed] [Google Scholar]. 20. Guedira M, Hrora A, Raïss M, El Alaoui M, Kettani F, Tounsi A et al. Tumeurs pseudopapillaires et solides du pancréas. J Chir. 2006; 143: 271–3. [PubMed] [Google Scholar].