Analysis of Imaging Findings of Solid Pseudopapillary Tumors of Pancreas

LI Zhi-bin; DUAN Ya-xi; LIU Wei

doi:10.3969/j.issn.1002-3429.2015.09.028

Abstract：Objective To analyze the CT and MRI features of solid pseudopapillary tumors of pancreas ( SPTP) and cause of misdiagnosis and the differential diagnostic criteria. Methods The CT and MRI images and clinical data of 19 cases of SPTP confirmed by pathology and operation were analyzed retrospectively. Results The group included three males and sixteen females and the mean age was 36. 6 years. Clinical presentation included abdominal discomfort or pain in 14 cases and a Palpable abdominal mass in another 5 cases. The tumor markers of all cases were negative. 16 patients were examined by CT and 3 patients were examined by MRI. All tumors were round or oval, among which, 7 were located in the head of pancreas and 1 located in the body of pancreas and 11 located in the tail of pancreas;regular shape and clear margin in 16, and irregu-lar shape and unclear margin in 3. The tumor showed solid-cystic (14 cases) or solid (3 cases) or cystic (2 cases). After dynamic contrast-enhanced scanning, the solid parts of the lesion was from mildly to moderately enhanced during arterial phase, and it was progressive (14 cases) or continuously filled (5 cases) during portal venous phase and equilibrium phase, and the cystic parts of the lesion showed no enhancement. Tumors of 16 cases were surrounded with complete capsule. Calcifi-cation could be seen in 11 cases. 7 cases had hemorrhagic tumor. The expansion of pancreatic duct and the vessel encasement were found in 2 cases respectively. In imaging diagnosis, 8 cases were diagnosed as with SPTP, 7 cases as cystadenoma ( cys-tadenocarcinoma) , pancreatic cancer in 3 cases, gastrointestinal stromal tumor in 1 case, and SPTP was pathologically proved in all the patients. Conclusion The imaging features of solid pseudopapillary tumors of pancreas are manifested by solid-cyst-ic, complete capsule, calcification and hemorrhagic and progressive enhancement. Improved awareness of these features can help preoperative diagnosis and correct selection of surgical approach.