CASE OF THE MONTH April 2018 M Granholm MD MPH PGY2 Diagnostic Radiology McMaster University Clinical History 21 year old female vague abdominal pain No previous imaging available CT Findings ID: 762524
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CASE OF THE MONTH April 2018 M. Granholm, MD, MPHPGY2 Diagnostic Radiology McMaster University
Clinical History 21 year old female, vague abdominal painNo previous imaging available
CT
Findings
Solid and cystic (white solid arrow) mass within dense rim calcifications (white curved arrow) Findings
Ultrasound
Findings
Findings Large well-defined mass with heterogeneous appearances, due to its solid (white solid arrow) and cystic (black curved arrow) composition
Solid and Pseudopapillary Epithelial Neoplasm SPEN
Solid and Pseudopapillary Epithelial Neoplasm The HighlightsClassically, young non-Caucasian woman (20s-30s) Well-defined, heterogeneous, large pancreatic mass with thick, enhancing capsule Solid most commonly, but can have variable cystic components and intratumoral hemorrhage Internal hemorrhage (fluid-fluid or hematocrit levels) HIGHLY characteristic feature Peripheral or central calcifications (45-50%) No biliary or pancreatic ductal obstruction (usually)
Solid and Pseudopapillary Epithelial Neoplasm Clinical PresentationIf symptomatic Vague abdominal pain
Solid and Pseudopapillary Epithelial Neoplasm ComplicationsHemorrhageBiliary obstruction
Solid and Pseudopapillary Epithelial Neoplasm TreatmentComplete surgical resectionAssociated with long-term survival even in the presence of metastatic disease
References Raman, P. (2018). Pancreatic solid and pseudopapillary neoplasm. https://app.statdx.com/document/pancreatic-solid-and-pseudopapilla -/fab08726-956c-4afd-8b32-889eb8517dd9?searchTerm=SPEN Weerakkody , Y. et al. (2018). Solid pseudopapillary tumor of the pancreas. Radiopedia , available from: https:// radiopaedia.org /articles/solid-pseudopapillary-tumour-of-the-pancreas-1