Unraveling the enigma: A comprehensive review of solid pseudopapillary tumor of the pancreas

Table 3 Differential diagnosis of solid pseudopapillary tumor of the pancreas

Disease	Female	Age (yr)	Marker	Clinicopathological features
SPTP	90%	20-40	β-catenin	Well-circumscribed; < 3 cm: Mainly solid; > 3 cm: Solid-cystic; myxoid stroma enveloping fibrovascular cores; discohesive epithelioid cells
Non-functional PNET	50%	50-60	CgA	Solid: Obviously enhanced with capsule ring-like enhancement; solid-cystic: Mural nodule, uneven wall; high rate of G2 and G3
ACC	< 50%	60	AFP	Enhanced solid with large mass having hypodense areas; heterogeneous enhancement; full of large polygonal cells with background necrosis, zymogen-rich and granular cytoplasm, cherry-red nucleoli
SCN	75%	55-70	NA	Honeycomb appearance, central scar; stellate scar in the center of the cyst cavity; clear serous fluid
MCN	> 95%	40-60	NA	Mucin secretion; disconnection from pancreatic duct; ovarian-like stroma; intracellular mucin
IPMN	50%	60-80	NA	Communication with pancreatic duct; absence of ovarian-like stroma; mucin
Pseudocyst	≤ 25%	Any	NA	History of pancreatitis or pancreatic trauma; high amylase in pancreatic juice
PBL	NA	< 10	AFP	Hypodense mass; central mass; squamous nest; well-defined margin; heterogeneous; enhanced; circumscribed, plump spindly cell whorls with squamous morules

SPTP: Solid pseudopapillary tumor of the pancreas; PNET: Pancreatic neuroendocrine tumor; CgA: Chromogranin A; ACC: Acinar cell carcinoma; AFP: Alpha-fetoprotein; SCN: Serous cystic neoplasms; MCN: Mucinous cystic neoplasms; IPMN: Intraductal papillary mucinous neoplasms; PBL: Pancreatoblastoma; NA: Not available.