Fact-sheet: Solid and papillary neoplasm of pancreas
Updated on 09/06/2019 at 8:45 AM
View all RADEOS cases associated with this fact-sheet
Definition
Rare pancreatic tumor (1 to 2% of exocrine pancreatic tumors), also known as solid pseudopapillary tumor of the pancreas or Frantz tumor.
Predominantly affects women (90%), with a mean age of 29 years.
Mixed solid-cystic tumor with low malignant potential (metastases in 8% of cases)
Recurrence observed in 10 to 15% of operated patients.
Clinical features
Asymptomatic in 30% of patients.
Nonspecific symptoms: abdominal pain, anorexia and nausea, epigastric mass.
CT
Large tumor, up to 20cm, well-defined by a thick capsule.
Heterogeneous solid-cystic content in variable proportion depending on intratumoral hemorrhagic changes;
Central or peripheral calcifications in 1/3 of cases;
Solid portions enhancing after injection at the periphery of the mass;
Necrotic-hemorrhagic cystic component usually central.
MRI
Well-defined heterogeneous lesion,
Hemorrhagic areas with T1 hyperintensity and T2 hypointensity
Thick discontinuous fibrous capsule with T2 hypointensity
Early heterogeneous peripheral enhancement with progressive fill-in on dynamic post-contrast series.
Possible peripheral or central calcifications, raising the differential of a serous or mucinous cystadenoma.
Management
Contraindication to biopsy.
In case of suspected SPN: R0 surgical resection.
Differential diagnosis
Possible central or peripheral calcifications, raising the differential of a serous or mucinous cystadenoma.
Purely solid forms mimicking a nonfunctioning neuroendocrine tumor.
Possible hepatic, nodal, or peritoneal metastases, raising the differential of pancreatic adenocarcinoma.