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Joseph Junewick, MD FACR
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Solid Pseudopapillary Tumor of the Pancreas

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

Teenager with abdominal pain and weight loss.


Case Images


Diagnosis

Solid pseudopapillary tumor of the pancreas

Findings

CT – Multiplanar images demonstrate a circumscribed exophytic mass emanating from the pancreatic tail.

Pathology – Distal pancreatectomy gross specimen shows round reddish mass from the pancreatic tail.

Discussion

Solid pseudopapillary tumor of the pancreas is typically a benign tumor found mainly in young non-Caucasian women between the 2nd and 3rd decades of life, although rare cases have been reported in children and men. Patients are often asymptomatic with normal laboratory data. The diagnosis is commonly made during abdominal imaging for other reasons. These tumors are typically large, occur most commonly in the pancreatic tail, displace rather than invade surrounding structures and rarely cause ductal obstruction. The well delineated margins represent a pseudocapsule composed of compressed pancreatic tissue and
reactive fibrosis. The differential diagnosis includes a nonfunctioning islet cell tumor, pancreatoblastoma, lymphoma, carcinoma and metastatic disease. CT usually demonstrates a well-encapsulated lesion with varying solid and cystic components owing to hemorrhagic degeneration. MR imaging typically demonstrates a well-defined lesion with heterogeneous signal intensity on T1- and T2-weighted images. US shows a well-encapsulated cystic and solid mass, but sometimes a mass may be purely solid or have internal septations or calcifications. Surgical resection is usually curative.

Reference

Choi JY, Kim JM, Kim JH et al. Solid Pseudopapillary Tumor of the Pancreas: Typical and Atypical Manifestations. AJR (2006); 187(2):W178-W186.

Coleman KM, Doherty MC, Bigler SA. Solid-Pseudopapillary Tumor of the Pancreas. Radiographics (2003); 23:1644-1648.

Low G, Panu A, Millo N, et al. Multimodality Imaging of Neoplastic and Nonneoplastic Solid Lesions of the Pancreas. RadioGraphics (2011); 31:993-1015.



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