540Solid pseudopapillary tumor of pancreas causing sinistral portal hypertension

Abstract

Solid-pseudopapillary tumour of the pancreas is a rare benign or low-grade malignant epithelial tumour that occurs mainly in young females. Pathologic and imaging findings include a well-defined, encapsulated pancreatic mass with cystic and solid components with hemorrhage. We report a 23-year-old woman that presented with epigastric pain of long duration and epigastric mass on palpation. MDCT demonstrated a large well defined heterogenous attenuation mass, containing hyperdense areas of hemorrhage mixed with solid enhancing and cystic non-enhancing areas, arising from the pancreatic body and tail. Splenic vein thrombosis was present with dilated splenoportal collateral vessels between splenic hilum and portal/ superior mesenteric veins and dilated vessels seen in the gastric wall with patent portal vein, compatible with sinistral portal hypertension. Typical imaging features and age and sex of the patient suggested a diagnosis of solid pseudopapillary tumor of pancreas complicated by segmental portal hypertension. Histopathology was confirmatory.