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Background and purpose: Solid pseudopapillary tumor of the pancreas (SPTP) is rare, and there are some differences between benign and malignant SPTP not only in clinical treatment but also in future prognosis. The purpose of this study was to investigate the characteristics of benign and malignant SPTP and differential diagnosis on computed tomography scan, in order to improve the accuracy of preoperative diagnosis. Methods: A total of 69 SPTP patients cofirmed by pathology were included. Each patient was diagnosed through the clinical and CT features by 3 radiologists. Results: Thirteen (18.84％) patients (9 females and 4 males) were confirmed as malignant SPTP. The tumors in 56 (81.16％) patients (45 females and 11 males) were diagnosed as benign SPTP. There was no significant difference in gender (P=0.458) between the groups. The mean age of malignant SPTP patients was significantly higher than that of benign SPTP patients [39 (16-56) years vs 31 (14-56) years, P=0.001]. The mean tumor size was 6.2(2.2-12.0)cm in malignant group and 5.5(1.2-13.0) cm in benign group, respectively. The size of tumor was equal or larger than 5.0 cm in 31 patients (benign vs malignant 21∶10, P=0.014). Twenty-eight lesions showed incomplete fibrous pseudocapsule (benign vs malignant 19∶9, P=0.028). There were no significant differences in lesion location, morphology, proportion of cystic or solid component between malignant and benign groups (P＞0.05). Conclusion: Malignant SPTP patients were significantly older than benign SPTP patients. The large tumor size (≥5 cm) and incomplete fibrous pseudocapsule may suggest malignancy of SPTP.
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Objective@#To explore the clinical characteristics, surgical procedures and prognosis of solid pseudopapillary tumor of the pancreas(SPTP).@*Methods@#The clinical and follow-up data of 55 cases with SPTP in Henan Tumor Hospital from June 2005 to April 2015 were retrospectively analyzed.@*Results@#There were 55 SPTP cases, including 7 males and 48 females. The age ranged from 16 to 76 (median, 33). Clinical presentations of SPTP were not specific. The mean size of the tumor was 7.6 cm (range from 2 to 25cm). Pancreatic head and tail were the most common locations of SPTP. All the patients received surgical resection with a definitive pathological diagnosis. Some immunohistochemical markers were mostly positive, including β-catenin, Vim, Syn, CD10, CD56, PR, etc. With a median follow-up of 53 months, the 1-year, 2-year and 5-year survival rate were 98.1%, 96.1% and 94.0%, respectively.@*Conclusions@#SPTP is an uncommon exocrine pancreatic neoplasm with low malignant potential, which frequently occurs in young women. Preoperative imaging can provide evidence for the selection of treatment modalities among which surgical resection ispreferred. Diagnosis still relies on pathology and immunohistochemistry.
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[Objective]To discuss the CT diagnosis and differential diagnosis of solid pseudopapillary tumor of the pancreas (SPTP).[Methods]The CT findings of 20 patients with SPTP proved by surgically pathology were retrospectively analyzed and summa?rized.[Results]SPTP were composed of solid and cystic components with surrounding capsule resulting to clear demarcation between tumor and normal pancreas without dilation of pancreatic duct. The tumor parenchyma was slightly hyperenhancement on arterial phase and showed gradual enhancement on venous and delayed phase.[Conclusions]The CT findings of SPTP have relative specifici?ty and can contribute to early diagnosis and differential diagnosis of SPTP.
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Objective To retrospectively analyze imaging features of multi-slica computed tomography (MSCT) and clinical characteristics of male patients with pancreas solid pseudopapillary tumor (SPT) and compare with that of female patients.Methods From November 2000 to October 2012,clinical data of 18 male patients and 94 female patients underwent MSCT examination and pathological diagnosed as SPT were retrospectively analyzed.Clinical characteristics and imaging features of MSCT of male and female patients with SPT were analyzed,which included lesion location,size,shape,encapsulation,calcification,internal composition,density and enhancement pattern of tumors.Rank sum test or x2 test was performed for statistical analysis.Results The median age of male patients with SPT was significantly older than that of female patients (39.0 (15.0,67.0) years vs 27.5 (11.0,63.0) years; U=2.865,P =0.005).There were no significant differences in clinical manifestation,lesion location and composition ratio of benign and malignant tumors between male and female patients with SPT (all P＞0.05).Imaging of MSCT indicated that the median maximum tumor diameter of male patients with SPT was significantly shorter than that of female patients (5.1 (1.0,11.6) cm vs 7.9 (2.5,18.7) cm; U=3.161,P=0.002).Solid tumors were more common in male patients compared with female patients (9/18 vs 5.3％ (5/94) ; x2 =30.606,P＜0.01).Conclusions The imaging features of male patients with SPT are different with those of females.For pancreas lesion in males,if imaging of MSCT shows more solid composition,small lesion and with typical enhancement patterns of SPT,the possibility of SPT should be considered.
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Background and purpose:Ultrasound is a regular screening method of solid pseudopapillary tumor of the pancreas (SPTP). This study was to summarize the diagnostic value of ultrasound to SPTP.Methods:Clinical and ultrasound data of 62 SPTP cases in Fudan University Shanghai Cancer Center were retrospectively collected and analyzed.Results:Five cases of SPTP were undetected by ultrasound in the group. The features of ultrasound including: large mass located at the body and tail of the pancreas, clear boundary and regular shape, low ultrasound with uneven signal, or low signal mixed with no signal. A few cases have calciifcation and blood signal. Most of the cases presented no dilation of main pancreatic duct and bile duct and regional lymph nodes enlargement. Conclusion:Ultrasound can be used to detect SPTP which has special ultrasound signal features.
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Solid pseudopapillary tumor (SPT) is a rare, indolent pancreatic neoplasm of young women and the prognosis after surgical resection is quite favorable. However, several cases of forming metastasis, showing recurrence, or invading adjacent organs have been reported. We present a case of a 14-year-old girl with an infiltrating SPT who underwent distal pancreatectomy with splenectomy and adjuvant chemoradiotherapy. At surgery, the tumor was found to extend into the splenic hilum. On the basis of vascular invasion, capsular injury and pancreatic parenchymal infiltration, the diagnosis of malignant SPT of the pancreas was made. The patient received adjuvant chemoradiotherapy and she is alive without recurrence of disease for 26 months. Although most SPTs show relatively indolent behavior with low-grade malignancy, particular attention should be paid to the patients with pathology suggesting a possible malignant behavior.
Subject(s)
Adolescent , Female , Humans , Chemoradiotherapy, Adjuvant , Neoplasm Metastasis , Pancreas , Pancreatectomy , Pancreatic Neoplasms , Prognosis , Recurrence , SplenectomyABSTRACT
Solid pseudopapillary tumor (SPT) is a rare, indolent pancreatic neoplasm of young women and the prognosis after surgical resection is quite favorable. However, several cases of forming metastasis, showing recurrence, or invading adjacent organs have been reported. We present a case of a 14-year-old girl with an infiltrating SPT who underwent distal pancreatectomy with splenectomy and adjuvant chemoradiotherapy. At surgery, the tumor was found to extend into the splenic hilum. On the basis of vascular invasion, capsular injury and pancreatic parenchymal infiltration, the diagnosis of malignant SPT of the pancreas was made. The patient received adjuvant chemoradiotherapy and she is alive without recurrence of disease for 26 months. Although most SPTs show relatively indolent behavior with low-grade malignancy, particular attention should be paid to the patients with pathology suggesting a possible malignant behavior.
Subject(s)
Adolescent , Female , Humans , Chemoradiotherapy, Adjuvant , Neoplasm Metastasis , Pancreas , Pancreatectomy , Pancreatic Neoplasms , Prognosis , Recurrence , SplenectomyABSTRACT
Objective To investigate the CT imaging features of solid pseudopapillary tumor of the pancreas (SPTP) and to improve the preoperative diagnostic accuracy. Methods A retrospective analysis was performed on the CT manifestations of 21 cases of SPTP confirmed by pathology and surgery. Results In the 21 cases of SPTP, 19 were young and middle-aged female (range: 9～29 years old). The lesions were located in the pancreatic head and neck in 13 cases, and in the pancreatic body and tail in 4 cases each. The maximum diameter of tumor was 3 ～ 15 cm (mean 7.5cm). CT showed a single, round-like, cystic and solid mass in the pancreas. Eighteen cases had a complete capsule, and 3 cases had poorly defined margin with surrounding tissue. 5 cases of tumor were encapsulated or appeared scattered calcification in the center, only 1 case had pancreatic duct dilation (about 5mm in diameter), and no patient had bile duct changes. After enhanced scanning, the tumor capsule and the solid part were mildly to moderately enhanced during arterial phase, and they were significantly enhanced during portal venous phase and equilibrium phase. The cystic part was not enhanced, but the capsule was significantly enhanced. Conclusions CT manifestations of solid pseudopapillary tumor of the pancreas have certain characteristics, and when combined with clinical and imaging manifestations, accurate diagnosis generally can be made.
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Solid pseudopapillary tumors of the pancreas are usually described as rare lesionswith low malignant potential and unpredictable behavior. The prognosis may be favorableeven with local or distant dissemination. Despite the steady increase of cases diagnosed,the pathogenesis of this neoplasm remains unclear. We present a case of an incidentaltumor discovered because of an acute abdomen in a postpartum woman without previousevidence of a tumor during the pregnancy.
Subject(s)
Neoplasms, Cystic, Mucinous, and Serous , Pancreatic Neoplasms , PancreasABSTRACT
Objective To summarize the current diagnostic and therapeutic advancement of solid pseudopapillary tumor of the pancreas.Methods Relevant literatures about the diagnosis and treatment of solid pseudopapillary tumor of the pancreas,which were published recently domestic and abroad were collected and reviewed.Results Solid pseudopapillary tumor of the pancreas is now considered to be a low-grade malignancy with characteristic clinical,imaging and pathological features.Resection is considered to be the optimal choice with favourable prognosis.Conclusion An awareness of the features may guide us to a correct diagnosis and treatment of this rare neoplasm,but the deep understanding of the disease needs the accumulation of more cases and fundamental research.
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Purpose:To study clinical and pathological features of solid-pseudopapillary tumor(SPT) of the pancreas. Methods:The clinical data were reviewed in four patients with SPT. Immunohistochemistry for Vim, CK8, CK18, Chromogranin, Sy, AAT, NSE, S-100 was performed in all four cases using EnVision. Results:All four patients were female. The mean age was 30 years. The tumors were composed of papillary and solid structures. The uniform cells were strongly diffuse positive for Vim, and strongly positive for focal AAT in four cases. Three cases were positive for NSE. All four cases were negative for Sy , Chromogranin and S-100. One case was poorly positive for CK8 and CK18. Conclusions:SPT of the pancreas, preferentially in young women, is a tumor with low malignant potential. Immunohistochemistry is very important in the diagnosis and differential diagnosis of SPT of the pancreas..