Robotic enucleation of a solid pseudopapillary neoplasm in a 9-year-old girl

Abstract

Objective: Here we reported the case of a 9-year-old girl with no relevant past medical or surgical history. Solid pseudopapillary neoplasms (SPN) is a rare pancreatic tumor, which is often observed in females in their second or third decades, but it can also be found in pediatric age. It is considered a low-grade malignant epithelial neoplasm with low metastatic rate and surgical resection represents the treatment of choice with an excellent long-term prognosis. Case report: A 9-year-old girl presented at our Emergency Department with a three days history of vomiting and vague abdominal pain. US showed an epi-mesogastric solid mass of 8 cm, diagnosis confirmed by the CT scan. A US-guided Tru-cut biopsy was performed obtaining the histologic diagnosis of Solid pseudopapillary neoplasm (Gruber-Frantz tumor). A Robotic enucleation of the neoplasm was performed, and histopathology confirmed an SPN with complete resection. In the case of low-malignant neoplasms like SPNs, enucleation, when feasible, represents the best surgical approach. Robotic procedures offer some technical and oncological advantages over minimally invasive techniques due to the stability of the operative field, the 3D and magnified vision and the articulated robotic arms. Conclusions: Robotic enucleation of solid pseudopapillary pancreatic tumors, when feasible, represents an excellent minimally invasive technique with a favorable long-term prognosis.

Keywords

• gruber-frantz tumor
• pancreatic tumor
• tru-cut biopsy
• robotic surgery
• tumor enucleation
• solid pseudopapillary tumor