Clinical diagnosis, treatment and prognosis analysis of children with pancreatic tumours.
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OBJECTIVE: To investigate the diagnosis, treatment, and prognosis of children with pancreatic tumours. METHODS: We conducted a retrospective review of patients ≤18 years of age with pancreatic neoplasms who underwent surgery at a single institution between 2010 and 2022. RESULTS: The most common histology among the 48 patients was solid pseudopapillary neoplasm of the pancreas (SPN, n = 32), followed by pancreatic blastoma (PB, n = 12), B-cell lymphoblastic lymphoma (n = 1), leukaemia (n = 1), pancreatic cancer (n = 1), and pancreatic neuroendocrine tumours (n = 1). The tumours were located in the head of the pancreas in 29 patients (10 patients underwent pancreaticoduodenectomy, 9 patients underwent Whipple, 7 patients underwent pancreatic tumour resection, and 3 patients underwent laparoscopic tumour enucleation). The tumours were located in the tail of the pancreatic body in 19 patients (10 patients underwent local resection of the pancreatic tumour, 5 patients underwent resection of the pancreatic body and tail and spleen, 3 patients underwent spleen-preserving distal pancreatectomy, and 1 patient underwent laparoscopic resection of the tumour). Patients with pancreatoblastoma, acute lymphoblastic leukaemia, B lymphoblastic lymphoma or pancreatic cancer were treated with regular chemotherapy. Forty-five patients (93.75%) were currently alive and disease free, and the median follow-up was 8.2 years (IQR: 2.0-14.3). Two patients with pancreatic blastoma died during the follow-up, and 1 patient with pancreatic cancer died due to tumour recurrence and progression after treatment. CONCLUSION: Paediatric pancreatic tumours are highly heterogeneous. Complete surgical resection that preserves organ function is the preferred treatment for children with pancreatic tumours.