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Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiologic-pathologic correlation
Gopinathan Anil1, Junwei Zhang, Nawal Ebrahim Al Hamar
1Department of Diagnostic Imaging, National University Hospital, Singapore; Department of Diagnostic Radiology, National University of Singapore Yong Loo Lin School of Medicine, Singapore. ivyanil10@gmail.com.
Diagnostic and Interventional Radiology (Ankara, Turkey)
|January 17, 2017
Summary
Solid pseudopapillary neoplasm (SPN) of the pancreas often presents as a mixed solid and cystic mass in young women. Smaller SPNs may be entirely solid, and while splenic invasion can occur, it does not impact long-term outcomes.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor, predominantly affecting young women.
- Understanding the imaging characteristics of SPN is crucial for accurate diagnosis and management.
Purpose of the Study:
- To evaluate the imaging features of pancreatic SPN using computed tomography (CT).
- To correlate radiologic findings with histopathologic characteristics of SPN.
Main Methods:
- Retrospective review of preoperative CT images from ten patients diagnosed with SPN.
- Analysis of tumor location, attenuation, enhancement, margin, shape, size, morphology, capsule, and calcification.
- Correlation of CT findings with histopathologic results.
Main Results:
- Distal pancreatic SPNs were larger on average (12.6 cm) compared to other locations (4.0 cm).
- A fibrous pseudocapsule was identified in 6/9 resected tumors and visualized on CT in 5.
- Mixed solid and cystic components were common (8/10), reflecting necrosis and hemorrhage; smaller lesions were purely solid.
- Calcifications were noted in four tumors; splenic invasion occurred in three of four tail tumors.
- No recurrence was observed at a median follow-up of 53 months post-resection.
Conclusions:
- A mixed solid and cystic pancreatic mass in a young woman suggests SPN.
- Smaller SPNs can be completely solid.
- Splenic invasion in pancreatic tail SPNs did not negatively affect long-term outcomes in this series.
