Multi-slice spiral CT findings and differential diagnosis of solid-pseudopapillary tumor of pancreas

Objective: To investigate the MSCT features and differential diagnosis of solid-pseudopapillary tumor of the pancreas (SPTP). Methods: The clinical and MSCT features of 34 patients with pathologically proven SPTP were retrospectively analyzed. Results: The tumors were located in the pancreatic head (10), head-neck (4), neck (6), body (2), body-tail (6), or tail (6) measuring > 3 cm (30) or ≤ 3 cm (4). The SPTP was round (25) or lobulated (9); solid (9), cystic-solid (20), or cystic (5). Calcification was seen in 14; pancreatic duct dilatation was present in 12 accompanied by bile duct dilatation in 3. The solid portions were hypo- or isodense with less contrast enhancement than the normal pancreatic tissue in the arterial phase and continuous enhancement in the venous and delayed phases. The cystic portions were hypodense without enhancement. The tumors were completely (30) or incompletely (4) encapsulated. 2 SPTP were complicated with peritoneal and liver metastases, and 3 showed malignant transformation. Preoperative diagnosis was correct in 28 and erroneous in 6. Conclusion: SPTP is seen most frequently in young women and may undergo malignant transformation with peritoneal and liver metastasis. MSCT features can aid diagnosis. (authors)