FRANTZ TUMOR- THE EXPERIENCE OF THE ONCOLOGICAL SURGERY SERVICE OF THE FEDERAL UNIVERSITY OF UBERL NDIA

The solid pseudo papillary tumor of the pancreas, also known as Frantz tumor is a rare malignant neoplasm that accounts for less than 1% of malignant pancreatic tumors. It usually affects young women, with an average age of 20 years. The clinical presentation may be asymptomatic, but may be present with abdominal pain or symptoms of compression of adjacent organs. The indicated treatment is a complete surgical resection, which generally has good results, with a low recurrence rate or distant metastases. We report the experience of the Oncology Surgery service of the Federal University of Uberlândia in the surgical treatment of Frantz Tumor. Three cases were followed during the period of 2009 to 2019, all female patients, aged 28 to 48 years who presented tumors located in the uncinate process and in the head of the pancreas. Two patients underwent a gastro duodenum pancreatectomy (in the form of Whipple) and the third underwent limited resection of the neoplasia, preserving pancreatic parenchyma and also the duodenum and the bile duct. None of the patients had complications in the immediate postoperative period. Comparing the long-term results, both patients who underwent Whipple evolved with exocrine pancreatic insufficiency requiring pancreatic enzyme supplementation to maintain nutritional intake, one of which presented delayed gastric emptying. The patient who underwent limited resection of the neoplasia evolved with better nutritional status, without the need for enzymatic supplementation or other nutrients, but presented with pancreatitis in the eighteenth postoperative period with good response to the clinical treatment. Surgery is the only effective therapy for this type of disease and Whipple mode surgery is widely performed for the treatment of neoplasia of the head of the pancreas; however, it is considered a highly complex operation with prolonged surgical time and may be associated with important morbidity and mortality. The present study demonstrates excellent survival rates associated with operative treatment and that, when possible, in selected cases, the option for a more conservative surgical technique with preservation of pancreatic parenchyma and other adjacent structures may benefit those who are sick with long-term morbidity deduction.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019