Thirteen Year Old Female with Vague Abdominal Pain • Xray of the Week
This 13 year old girl presented with vague abdominal pain and nausea. The patient went to surgery 2 days after the CT and MRI shown here. What did the surgeon find?
Figure 1 A: CT showing a large pancreatic mass with peripheral enhancement.
B: Coronal T1 weighted image demonstrates the pancreatic mass with central necrosis and peripheral enhancement.
Figure 2 A: Axial FSE T2 weighted image showing a large pancreatic mass with central necrosis and hemorrhage.
B: Axial LAVA post contrast T1 weighted image demonstrates the pancreatic mass with central necrosis and peripheral enhancement.
Solid pseudopapillary tumor of the pancreas (SPT) is a rare neoplasm of the pancreas seen predominantly in young Asian and African-American females between ages 10 and 20. Although most tumors are benign, about 15% may be malignant. As in this case, CT and MRI usually demonstrate a peripheral enhancing large mass. MRI shows heterogeneity on all sequences due to necrosis and hemorrhage. Differential diagnosis includes serous cystadenoma, mucinous cystic neoplasm, islet cell tumors, and pancreatoblastoma. Complete surgical resection is usually curative.
1. Coleman KM, Doherty MC, Bigler SA. Solid-pseudopapillary tumor of the pancreas. Radiographics. 23 (6): 1644-8
2. Choi JY, Kim MJ, Kim JH et-al. Solid pseudopapillary tumor of the pancreas: typical and atypical manifestations. AJR Am J Roentgenol. 2006;187 (2): W178-86.
Kevin M. Rice, MD is the president of Global Radiology CME
Dr. Rice serves as the Chair of the Radiology Department of Valley Presbyterian Hospital in Los Angeles, California and is a radiologist with Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015 Dr. Rice founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field. Due to his online teaching initiative, Dr. Rice was nominated and became a semifinalist for a "Minnie" award for the Most Effective Radiology Educator in 2016.
Follow Dr. Rice on Twitter @KevinRiceMD
All Posts by Kevin Rice, MD