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Published byLars-Erik Christophersen Modified over 6 years ago
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CASE OF THE MONTH April 2018 M. Granholm, MD, MPH
PGY2 Diagnostic Radiology McMaster University
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Clinical History 21 year old female, vague abdominal pain
No previous imaging available
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CT
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Findings
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Findings Solid and cystic (white solid arrow) mass within dense rim calcifications (white curved arrow)
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Ultrasound
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Findings
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Findings Large well-defined mass with heterogeneous appearances, due to its solid (white solid arrow) and cystic (black curved arrow) composition
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Solid and Pseudopapillary Epithelial Neoplasm
SPEN
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Solid and Pseudopapillary Epithelial Neoplasm The Highlights
Classically, young non-Caucasian woman (20s-30s) Well-defined, heterogeneous, large pancreatic mass with thick, enhancing capsule Solid most commonly, but can have variable cystic components and intratumoral hemorrhage Internal hemorrhage (fluid-fluid or hematocrit levels) HIGHLY characteristic feature Peripheral or central calcifications (45-50%) No biliary or pancreatic ductal obstruction (usually)
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Solid and Pseudopapillary Epithelial Neoplasm Clinical Presentation
If symptomatic Vague abdominal pain
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Solid and Pseudopapillary Epithelial Neoplasm Complications
Hemorrhage Biliary obstruction
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Solid and Pseudopapillary Epithelial Neoplasm Treatment
Complete surgical resection Associated with long-term survival even in the presence of metastatic disease
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References Raman, P. (2018). Pancreatic solid and pseudopapillary neoplasm. pseudopapilla-/fab c-4afd-8b eb8517dd9?searchTerm=SPEN Weerakkody, Y. et al. (2018). Solid pseudopapillary tumor of the pancreas. Radiopedia, available from: the-pancreas-1
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