Role of preoperative multidetector computed tomography diagnosis of solid pseudopapillary tumors of the pancreas with postoperative surgical and histopathological correlation

Abstract

Purpose: The purpose of this study was to evaluate the role of preoperative multidetector computed tomography (MDCT) diagnosis of solid pseudopapillary tumors (SPTs) of the pancreas with postoperative surgical and histopathological correlation. Materials and Methods: A prospective study was conducted in our institute for MDCT evaluation of patients with ultrasound-proven pancreatic tumors. Preoperative diagnosis of SPT was given in 10 of 36 total patients evaluated. These findings were correlated with surgical and histopathological findings. Results: A preoperative MDCT diagnosis of SPT was given in 10 patients on the basis of characteristic CT appearances, of which 9 were confirmed by postoperative histopathology. One was a histopathological examination (HPE) proven to be a neuroendocrine tumor. Two MDCT-negative but HPE-positive cases gave a total of 11 of 36 patients. 10 patients were females with a mean age of 27 (range 16-38 years). 6 lesions were identified in the head, with the average size of the lesions being 6.5 cm. No SPTs with malignant features were diagnosed on MDCT or HPE in our study. The sensitivity of MDCT to identify SPT in this series is 81.81%, specificity 96%, positive predictive value of 90%, negative predictive value of 92.31%. Conclusion: MDCT has a high specificity and positive predictive value with higher negative predictive values for diagnosing SPTs. However, atypical lesions pose a diagnostic challenge. A diagnosis with a greater degree of confidence can be made using knowledge of characteristic appearance on MDCT along with clinical correlation. The majority are benign, but follow-up is suggested if signs of aggressiveness are identified radiologically or by HPE.