Solid pseudopapillary tumor of the pancreas: cross-sectional imaging and pathologic correlation.

OBJECTIVE

This study aimed to evaluate the cross-sectional imaging features of solid pseudopapillary tumor of the pancreas (SPTP) with pathologic correlation.

METHODS

Imaging features of 29 cases with SPTP proven by histopathologic examinations, including 26 women and 3 men with a mean age of 27 years, were retrospectively investigated and correlated to their pathologic findings. According to the largest diameter, all cases were divided into 23 large tumors (>3.0 cm) and 6 small ones (< or =3.0 cm).

RESULTS

Large tumors commonly displayed the typical imaging features: a large well-encapsulated mass with varying solid-cystic and hemorrhagic areas and early peripheral heterogeneous enhancement with progressive fill-in on dynamic contrast-enhanced examination, which agreed with their pathologic findings: a large fibrous pseudocapsule-surrounded mass with variegated and variable combinations of solid, hemorrhagic, or cystic-necrotic areas in cut surface. The computed tomographic and magnetic resonance imaging features of small tumors were atypical: a small rarely encapsulated mass without observed hemorrhagic areas and cystic changes with gradual enhancement less than normal pancreatic parenchyma on dynamic contrast-enhanced images.

CONCLUSIONS

Imaging appearances were different between large and small SPTPs. Compared with computed tomography, magnetic resonance imaging was more powerful to identify the capsule, solid-cystic portions, and hemorrhagic areas of SPTP and to avoid misdiagnosis.