Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography

Figure 1 Pathologically confirmed benign SPT in a 24-year-old woman with abdominal discomfort for 1 year. A: Axial image at arterial phase revealed a low-attenuation mass in the pancreatic head. The surrounding vessels were displaced; B: The MIP CTA image identified that the tumor (*) displaced the gastroduodenal artery (GDA) without infiltration; C: The MPVR image demonstrated that tumor compressed the portal vein (PV) with a smooth border. There was no evidence suggesting invasion; D: Hemorrhagic and cystic areas (dark areas) were detected in the gross specimen. The capsule was intact.

Figure 2 Malignant SPT in a 35-year-old woman with abdominal pain and mass for 6 mo. A: A mass measuring 13 x 5.5 cm was detected on axial MDCT imaging in the pancreatic body. The mass was markedly enhanced and superimposed by abnormal enhancement of tiny vessels at the arterial phase. The interface between the tumor and the adjacent pancreatic parenchyma was blurred in that the tumor apparently infiltrated the surrounding pancreas; B: At the portal venous phase, the axial image demonstrated the heterogeneity of cystic and solid components inside the tumor. The peritumoral capsule was not smooth, which was consistent with capsular invasion. The portal vein was deformed by tumoral invasion; C: Coronal MPVR image showed the tumoral invasion resulting in the narrowing and irregularity of portal vein (PV).

Figure 3 Pathologically confirmed benign SPT in a 30-year-old woman with abdominal pain for about 3 mo. A: A heterogeneously low-attenuation mass was identified in the pancreatic head on the axial MDCT image at the arterial phase. The capsule was irregular and not attached to the adjacent, pancreas implying invasion outside the mass. The peripheral portion of the mass close to the duodenum was enhanced significantly and the duodenum was infiltrated; B: MPVR image revealed the irregularity and narrowing of the portal vein (PV) indicating vascular invasion; C: Invasion into the duodenum was revealed in the gross specimen of the tumor.