WOFAPS 2025 8th World Congress of Pediatric Surgery

PRIYA MATHEW, Sajid Qureshi

TATA MEMORIAL HOSPITAL, MUMBAI, INDIA

PURPOSE:
Pediatric pancreatic tumors are extremely rare, accounting for < 0.1% of all childhood cancers. Broadly categorized as either epithelial or non-epithelial. Most common exocrine tumor is solid pseudopapillary neoplasm (SPN), while pancreatoblastoma (PBL) is the most common malignant exocrine tumor. Malignant tumors necessitate radical surgical resection. Benign and low-grade malignant tumors may be treated with parenchyma-sparing procedures. Aim of this study is to review our experience in the management, outcome of pancreatic tumors at our institute.

METHODS:

Retrospective analysis of 17 patients with pancreatic tumors, who underwent treatment, from December 2011 to June 2025 was done. Collected data included clinical details, chemotherapy, operative details, histopathology, complications, outcomes, etc.

RESULTS:
Total 17 patients (12 females) were included. Histopathological diagnoses were PBL (07), SPN (10). Median age was 10 years. Four received neoadjuvant chemotherapy (PLADO). One underwent Trans arterial chemoembolization & Radio frequency ablation. Four had regional lymph node metastasis, three had remote (02 Liver, 01 Lung) metastasis. Surgeries performed include pylorus preserving pancreaticoduodenectomy (09), Pylorus resecting pancreaticoduodenectomy (01), Central pancreatectomy (01), Distal pancreatectomy (02), Distal pancreatosplenectomy (02), Total pancreatectomy, splenectomy, total gastrectomy (01) with 1 patient deemed inoperable on exploration. Major vascular involvement included Superior mesenteric vein (01) and Portal vein (01) thrombus requiring thrombectomies and Common hepatic artery repair in 01 patient. Postoperative complications included Delayed gastric emptying (02), Dysphagia (01), Gastrocutaneous fistula (01), Post operative pancreatic fistula (01), Chylous ascites (02). Two were lost to follow up, three had recurrences. Rest other patients are under follow-up without local, remote recurrence with no sequelae of chemotherapy till date. Follow-up ranged from 01 - 156 months.

CONCLUSION:
PBL and SPN are the most common pediatric pancreatic tumors, best managed by complete surgical resection. Careful evaluation, multidisciplinary team approach, individualized surgical planning, early appropriate chemotherapy in responding tumors are necessary for better outcome