Solid pseudopapillary tumor of the pancreas

Changed by Yuranga Weerakkody, 7 Oct 2014

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A solidSolid pseudopapillary tumour (SPT) of pancreas is a rare (usually benign) pancreatic tumour. 

Epidemiology

They are extremly rare and thought to account for 1-2% of exocrine pancreatic tumours. They tend to present in young non-Caucasian females around the 2nd and 3rd decades of life. 

Clinical presentation

Most patients are asymptomatic at diagnosis. They may occasionally present with a gradually enlarging abdominal mass or vague abdominal pain. 

Pathology

The tumours frequently contain varying amounts of necrosis, hemorrhage, and cystic change. Lesions can be large at time of diagnosis (median size ~ 8 cm 2)

Location

There is a greater predilection to occur at pancreatic tail.

Associations

Radiographic features

CT 

Usually seen as a well-encapsulated lesion with varying solid and cystic components owing to haemorrhagic degeneration. Following IV contrast administration, enhancing solid areas are typically noted peripherally, whereas cystic spaces are usually more centrally located. Calcifications and enhancing solid areas may be present at the periphery of the mass.

MRI

Typically demonstrates a well-defined lesion. May show a pure solid consistency in ~ 80% of cases 6.

Reported signal characteristics include

  • T1: - low low to heterogeneous signal intensity 1,6
  • T2: - heterogenous heterogenous to high signal intensity 1,6
  • C+ (Gd) - can show heterogenous and slowly progressive enhancement

Treatment and prognosis

While most lesions are benign, ~ 15% can be malignant. Complete resection is associated with long-term survival even in the presence of metastatic disease.

EtymologyHistory and etymology

It was first described by Frantz et.al in 1959 4-5.

See also

  • -<p>A <strong>solid pseudopapillary tumour (SPT) of pancreas</strong> is a rare (usually benign) pancreatic tumour. </p>
  • -<h4>Epidemiology</h4>
  • -<p>They are extremly rare and thought to account for 1-2% of exocrine pancreatic tumours. They tend to present in young non-Caucasian females around the 2<sup>nd</sup> and 3<sup>rd</sup> decades of life. </p>
  • -<h4>Clinical presentation</h4>
  • -<p>Most patients are asymptomatic at diagnosis. They may occasionally present with a gradually enlarging abdominal mass or vague abdominal pain. </p>
  • -<h4>Pathology</h4>
  • -<p>The tumours frequently contain varying amounts of necrosis, hemorrhage, and cystic change. Lesions can be large at time of diagnosis (median size ~ 8 cm <sup>2</sup>)</p>
  • -<h5>Location</h5>
  • -<p>There is a greater predilection to occur at pancreatic tail.</p>
  • -<h5>Associations</h5>
  • -<ul><li>
  • -<a title="pancreatic dorsal agenesis" href="/articles/pancreatic-dorsal-agenesis">pancreatic dorsal agenesis</a> - possible association <sup>5</sup>
  • -</li></ul><h4>Radiographic features</h4>
  • -<h5>CT </h5>
  • -<p>Usually seen as a well-encapsulated lesion with varying solid and cystic components owing to haemorrhagic degeneration. Following IV contrast administration, enhancing solid areas are typically noted peripherally, whereas cystic spaces are usually more centrally located. Calcifications and enhancing solid areas may be present at the periphery of the mass.</p>
  • -<h5>MRI</h5>
  • -<p>Typically demonstrates a well-defined lesion. May show a pure solid consistency in ~ 80% of cases <sup>6</sup>.</p>
  • -<p>Reported signal characteristics include</p>
  • -<ul>
  • -<li>
  • -<strong>T1</strong> - low to heterogeneous signal intensity <sup>1,6</sup>
  • -</li>
  • -<li>
  • -<strong>T2</strong> - heterogenous to high signal intensity <sup>1,6</sup>
  • -</li>
  • -<li>
  • -<strong>C+ (Gd)</strong> - can show heterogenous and slowly progressive enhancement</li>
  • -</ul><h4>Treatment and prognosis</h4>
  • -<p>While most lesions are benign, ~ 15% can be malignant. Complete resection is associated with long-term survival even in the presence of metastatic disease.</p>
  • -<h4>Etymology</h4>
  • -<p>It was first described by <strong>Frantz</strong> et.al in 1959 <sup>4-5</sup>.</p>
  • -<h4>See also</h4>
  • -<ul><li><a title="Pancreatic neoplasms" href="/articles/pancreatic_neoplasms">pancreatic neoplasms</a></li></ul>
  • +<p><strong>Solid pseudopapillary tumour (SPT) of pancreas</strong> is a rare (usually benign) pancreatic tumour. </p><h4>Epidemiology</h4><p>They are extremly rare and thought to account for 1-2% of exocrine pancreatic tumours. They tend to present in young non-Caucasian females around the 2<sup>nd</sup> and 3<sup>rd</sup> decades of life. </p><h4>Clinical presentation</h4><p>Most patients are asymptomatic at diagnosis. They may occasionally present with a gradually enlarging abdominal mass or vague abdominal pain. </p><h4>Pathology</h4><p>The tumours frequently contain varying amounts of necrosis, hemorrhage, and cystic change. Lesions can be large at time of diagnosis (median size ~ 8 cm <sup>2</sup>)</p><h5>Location</h5><p>There is a greater predilection to occur at pancreatic tail.</p><h5>Associations</h5><ul><li>
  • +<a href="/articles/pancreatic-dorsal-agenesis">pancreatic dorsal agenesis</a> - possible association <sup>5</sup>
  • +</li></ul><h4>Radiographic features</h4><h5>CT </h5><p>Usually seen as a well-encapsulated lesion with varying solid and cystic components owing to haemorrhagic degeneration. Following IV contrast administration, enhancing solid areas are typically noted peripherally, whereas cystic spaces are usually more centrally located. Calcifications and enhancing solid areas may be present at the periphery of the mass.</p><h5>MRI</h5><p>Typically demonstrates a well-defined lesion. May show a pure solid consistency in ~ 80% of cases <sup>6</sup>.</p><p>Reported signal characteristics include</p><ul>
  • +<li>
  • +<strong>T1:</strong> low to heterogeneous signal intensity <sup>1,6</sup>
  • +</li>
  • +<li>
  • +<strong>T2:</strong> heterogenous to high signal intensity <sup>1,6</sup>
  • +</li>
  • +<li>
  • +<strong>C+ (Gd)</strong> - can show heterogenous and slowly progressive enhancement</li>
  • +</ul><h4>Treatment and prognosis</h4><p>While most lesions are benign, ~ 15% can be malignant. Complete resection is associated with long-term survival even in the presence of metastatic disease.</p><h4>History and etymology</h4><p>It was first described by <strong>Frantz</strong> et.al in 1959 <sup>4-5</sup>.</p><h4>See also</h4><ul><li><a href="/articles/pancreatic-neoplasms">pancreatic neoplasms</a></li></ul>

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