Diagnosis of solid-pseudopapillary tumor of the pancreas and the value of post-processing in the surgery by spiral CT

Abstract

To study the CT manifestations of the solid-pseudopapillary tumor of the pancreas (SPTP) and to explore the value of post-processing in the surgery. Clinical and CT features of 14 patients with SPTP proved pathologically were retrospectively analyzed. (1) 13 tumors were composed of different proportions of solid and cystic parts and 1 tumor was composed of solid part only. The solid portions demonstrated slight enhancement in the arterial phase and marked enhancement in the portal venous phase on post-contrast CT. The cystic portions appeared hypo-attenuation on both pre- and post-contrast CT images. Tumors were encapsulated and the capsule enhanced markedly with well-defined margins on post-contrast images. (2) Dilatation of the common bile duct or pancreatic duct wasn't seen in all of the cases and 1 case with the right adrenal ganglioneuroma. (3) 5 tumors located in the head of the pancreas, 3 of which with the superior mesenteric vein compression and displacement, in 2 cases the vessels were partially encapsulated by tumor. 6 tumors located in the tail of the pancreas, 3 of them with splenic hilum compression and multiple splenic vein tortuosity and dilatation, the veins drained into superior mesenteric vein anteriorly and posteriorly of the tumor. Splenic vein compression and posterior displacement occurred in 2 cases. In one case, there was no clear margin between the tumor and the splenic hilum. The SPTP has characteristic CT findings and correct diagnosis could be made by combining clinical features. The relationship of the lesions and surrounding structures could be revealed by the post-processing and was helpful for the operation.