CT differentiation of solid serous cystadenoma vs endocrine tumor of the pancreas

Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature

Background

Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially small microcystic SCA.

Case presentation

This was a case of a 27-year-old male patient with microcystic SCA causing difficulty in the differential diagnosis from pancreatic neuroendocrine neoplasm (pNEN). A pancreatic tail mass was incidentally discovered on abdominal ultrasound (US). A contrast-enhanced computed tomography (CT) scan revealed a solid tumor measuring 13 mm with early enhancement in the arterial phase at the pancreatic tail. The tumor showed low intensity on T1-weighted magnetic resonance image, high intensity on T2-weighted image, and a slightly hyperechoic mass on endoscopic US (EUS). EUS-fine needle aspiration (EUS-FNA) did not lead to a definitive diagnosis. The tumor was clinically diagnosed as a pNEN, and a laparoscopic spleen-preserving distal pancreatectomy using the Warshaw technique was performed. The final histopathological diagnosis was microcystic SCA.

Conclusion

Small microcystic SCA is difficult to distinguish from a hypervascular pancreatic tumor such as pNEN on imaging studies, and it is necessary to focus on the tumor echogenicity of EUS to differentiate microcystic SCA from pNEN preoperatively.

Distinguishing pancreatic solid serous cystadenomas from nonfunctional pancreatic neuroendocrine tumors by computed tomography: A propensity score analysis

This study aims to evaluate the utility of calculated computed tomography (CT) attenuation value ratio (AVR) and enhancement pattern in distinguishing pancreatic solid serous cystadenomas (SCAs) from nonfunctional pancreatic neuroendocrine tumors (NF-pNETs). A total of 142 consecutive patients with 22 solid SCAs and 120 NF-pNETs confirmed by pathology were included in this retrospective study. All patients underwent preoperative contrast-enhanced CT and were categorized into 2 groups, solid SCA and NF-pNET groups. Patients with NF-pNETs were matched to patients with solid SCAs via propensity scores. AVR was measured and defined as: attenuation value of tumor/attenuation value of normal pancreas. AVR and enhancement pattern performance were assessed according to the discriminative abilities of patients. After matching, 29 patients were allocated to the NF-pNET group. Before matching, sex, age, and the peak enhanced value phase were significantly different between solid SCA and NF-pNET patients (P < .05). After matching, no significant difference was observed between both groups (P > .05). Solid SCAs AVRs were significantly smaller than NF-pNETs AVRs in all unenhanced, arterial, portal venous, and delayed phases (P < .05). Solid SCAs showed significantly more wash-in and wash-out enhancement patterns than NF-pNETs (P < .05). For unenhanced, arterial, portal venous, and delayed phases, and enhancement pattern, the area under the curve (AUC) values were 0.96, 0.72, 0.80, 0.85, and 0.86, respectively. Low AVR on unenhanced CT and wash-in and wash-out enhancement patterns were useful for differentiating solid SCAs from NF-pNETs and may be useful for clinical decisions, a clearer opinion will be formed with further studies to be conducted with larger patient numbers.

The Elusive Appearance of Hyperenhancing Solid Serous Cystadenoma of the Pancreas—Radio-Pathological Correlation

Serous cystadenomas account for ~10 to 29% of pancreatic cystic tumors. Solid serous cystadenoma (SSCA) is a rare variant, first described in 1996, with imaging characteristics different from the classical serous cystadenoma of the pancreas and can cause a diagnostic dilemma due to its resemblance to other solid tumors of the pancreas. To the best of our knowledge, only 22 cases of SSCA of pancreas have been reported till date.

A 50-year-old female patient underwent contrast-enhanced computed tomography (CECT) of the abdomen for a hypoechoic lesion detected in the body of the pancreas during ultrasound (US) examination. Due to the hyperenhancement of the well-circumscribed lesion in the arterial phase, a provisional diagnosis of neuroendocrine tumor was considered. Gallium 68-labeled somatostatin-analog (Ga 68-DOTANOC) positron emission tomography CT scan did not show any uptake within the lesion and endoscopic US (EUS)-guided fine-needle aspiration cytology (FNAC) was also inconclusive. She underwent laparotomy and the lesion was enucleated and it was proven to be a serous microcystadenoma on postoperative histopathologic examination.

A diagnosis of SSCA should be considered for solid-appearing pancreatic lesions with characteristic CECT features such as arterial phase hyperenhancement, and immediate washout, along with negative results on DOTANOC scan and EUS-guided FNAC. Malignant transformation of SSCA has not been reported till date, and hence these can be safely followed up, instead of invasive surgery.

Computed tomography and magnetic resonance imaging features of solid serous cystadenomas of the pancreas

Solid serous cystadenomas (SSC) of the pancreas are the rarest benign type of serous cystic neoplasms and are frequently misdiagnosed, resulting in unnecessary invasive surgical procedures. A retrospective study was performed to collect imaging features of SSC using computed tomography (CT) and magnetic resonance imaging. The clinical data and imaging study of 5 female patients with pathologically confirmed SSC (mean age, 44.2 years; range, 23-69 years) diagnosed between January 2006 and July 2017 were retrospectively analyzed. The imaging study was assessed by two experienced radiologists in consensus. All patients had tumors with a mean size of 2.3 cm (range, 1.5-3.2 cm; 4/5 lesions ≤3 cm). The tumors were located in the tail of pancreas in 3 cases and in the neck of the pancreas in 2 cases. The tumors were all well defined, with an ovoid and lobulated shape and fibrous capsules. Consequently, they presented as low density on unenhanced CT images, marked hyperintensity on T2-weighted images in 4 cases and slight hyperintensity in 1 case. However, they exhibited heterogeneous wash-in and wash-out enhancement in 2 cases and moderate and prolonged enhancement in 3 cases. The apparent diffusion coefficient (ADC) values of the lesions were >2×10^-3 mm²/sec. Therefore, a small tumor size, signal intensity on T2-weighted images, high ADC values, fibrous capsules and enhancement patterns may be indicative imaging features of SSCs.

Multiple solid pancreatic lesions: Prevalence and features of non-malignancies on dynamic enhanced CT

OBJECTIVE

To determine the prevalence of multiple solid pancreatic lesions on dynamic enhanced CT performed for suspected pancreatic diseases, and to identify CT features of non-malignancies.

METHODS

We investigated 8096 consecutive patients who underwent dynamic enhanced CT pancreas protocol at a tertiary center over 40 months. The final clinical /pathological diagnosis served as reference standard. The diagnostic accuracy of dynamic enhanced CT for non-malignancies was calculated. A univariate and multivariate analysis was conducted to identify features that predict non-malignancies.

RESULTS

Multiple solid pancreatic lesions were identified in 121 patients. The prevalence of non-malignancies was 19.8% (24/121). The most common non-malignancy was autoimmune pancreatitis (n = 21; 17.4%). Common lesions with malignant potential included neuroendocrine neoplasia (n = 62; 51.2%), ductal adenocarcinoma (n = 15; 12.4%), metastasis (n = 9; 7.4%), and lymphoma (n = 7; 5.8%). Dynamic enhanced CT had a sensitivity of 79.2% and a specificity of 92.8% for diagnosing non-malignancies. Elevated serum IgG4 level (p < 0.001), hypo-enhancement in arterial phase (p = 0.001), hyper-enhancement in equilibrium phase (p = 0.009) and location in both proximal and distal pancreas (p = 0.036) were predictors of non-malignancies, whereas pancreatic duct morphology and vascular invasion status were not.

CONCLUSION

Multiple solid pancreatic lesions were rare, with a wide spectrum. Dynamic enhanced CT provides clues for identifying non-malignancies.

Middle segment pancreatectomy for a solid serous cystadenoma diagnosed by MRCP and review of the literature: A case report

Solid serous cystadenoma of the pancreas is the rarest subtype of serous cystadenoma. Cystic structures are difficult to recognize by imaging studies. In the clinical setting, it is crucial to discriminate a solid serious cystadenoma from other solid pancreatic tumors. The present study reported a case of solid serous cystadenoma in which the magnetic resonance cholangiopancreatography (MRCP) findings were useful for diagnosis and decision-making regarding the surgical strategy, with a review of the previous reports of solid serous cystadenoma. A 50-year-old woman was referred to our hospital for investigation of a pancreatic body mass. A 2-cm hypervascular solid tumor was revealed by computed tomography. No typical radiological imaging findings of small cysts were detected, such as a honeycomb structure, and an adequate specimen could not be gained by biopsy under endoscopic ultrasonography. However, the tumor showed high intensity on MRCP, suggesting its cystic nature. A solid serous cystadenoma was suspected based on these radiological findings, and middle segment pancreatectomy was performed as a function-preserving surgery. The histological findings were compatible with a solid serous cystadenoma. In conclusion, MRCP imaging may be helpful for diagnosis and decision-making regarding the most appropriate surgical method for solid serous cystadenomas.

Pancreatic solid serous cystadenoma treated by laparoscopy: Presentation of a new case report and review of the literature

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Solid-type serous cystadenoma of the pancreas is pauci-symptomatic.

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Preoperative diagnosis is often misdiagnosis with other solid pancreatic tumors.

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Laparoscopic resection is feasible for treatment with good prognosis.

Solid serous cystadenoma is an uncommon benign pancreatic tumor, with only, including this case, 21 cases published so far. It is often misdiagnosis with other malignant pancreatic tumors.

Below we report a new case of a solid serous cystadenoma of the pancreas treated by laparoscopic distal pancreatectomy in 53-year-old female who presented with epigastric pain. Histological and immunohistochemical examination revealed a solid serous cystadenoma of the pancreas. Preoperative diagnosis of this subtype of serous cystadenoma is difficult, and, due to its benign nature, conservative resection of the tumor is the recommended treatment.

After analyzing the literature, including this case from our department, we discuss clinical presentation, imaging characteristics and histopathological findings, considering in particular difficulties in preoperative diagnosis, feasibility of laparoscopic resection.

Enhancing pancreatic mass with normal serum CA19-9: key MDCT features to characterize pancreatic neuroendocrine tumours from its mimics

OBJECTIVES

To determine key MDCT features for characterizing pancreatic neuroendocrine tumours (PNET) from their mimics, which manifest as enhancing pancreatic mass with normal serum CA19-9 level.

METHODS

This retrospective study had institutional review board approval and informed consent was waived. Preoperative multiphase MDCT of 74 patients with enhancing pancreatic masses and normal serum CA19-9 levels were included. Surgical pathologies were PNET (n = 42), microcystic serous cystadenomas (m-SCN, n = 12) and solid pseudopapillary epithelial neoplasms (SPEN, n = 20). Two radiologists independently evaluated CT images with a checklist of findings. Frequencies of findings with each disease entity were compared. Diagnostic accuracy was assessed using the key MDCT features alone and in combination. Inter-observer agreement was evaluated.

RESULTS

The most common findings for PNET were mosaic morphological pattern (33/42, 78.6%) and enhancement peak in pancreatic arterial phase (PAP, 32/42, 76.2%), for m-SCN were honeycomb pattern (9/12, 75.0%) and enhancement peak in PAP (10/12, 83.3%) and for SPEN were melting icecream pattern (16/20, 80.0%) and hypo-enhancement in all phases (18/20, 90.0). Using a combination of morphological patterns and enhancement features, PNET was identified with 88% sensitivity and 81% specificity, m-SCN was identified with 83% sensitivity and 94% specificity, and SPEN was identified with 90% sensitivity and 91% specificity. Inter-observer agreement concerning CT findings was good to excellent (κ = 0.68 to 0.81, all p < 0.01).

CONCLUSIONS

Morphological features and enhancement patterns on MDCT are key features for characterizing enhancing pancreatic mass with normal serum CA19-9. PNET could be differentiated from its mimics with high accuracy.

Pancreatic serous cystic neoplasms accompanying other pancreatic tumors

Serous cystic neoplasms (SCNs) are benign cystic neoplasms that predominantly occur in the tail of the pancreas in elderly women. It is well known that patients with von Hippel-Lindau syndrome can develop SCNs and neuroendocrine tumors in the pancreas. However, our understanding on SCNs accompanying other pancreatic tumors (SCNAOPTs) is limited. We compared the clinicopathological features of 15 surgically resected SCNAOPTs with 259 conventional SCNs. The prevalence of SCNAOPT was 5%. The SCNAOPTs were significantly smaller than conventional solitary SCNs, and they were more commonly observed in the head of the pancreas, whereas conventional solitary SCNs were more frequently noted in the body and tail. However, no differences were found in terms of sex, patient age, or the gross patterns of the SCNs. Accompanying neoplasms included 7 intraductal papillary mucinous neoplasms, 1 colloid carcinoma arising from intraductal papillary mucinous neoplasm, 6 neuroendocrine tumors, and 1 solid pseudopapillary neoplasm. Four neuroendocrine tumors associated with von Hippel-Lindau syndrome occurred as multiples, whereas 2 neuroendocrine tumors without von Hippel-Lindau syndrome were solitary. In summary, SCNAOPTs comprise 5% of all SCNs and tend to be smaller and located in the head of the pancreas. Common accompanying tumors include intraductal papillary mucinous neoplasms, neuroendocrine tumors, and other neoplasms such as colloid carcinoma and solid pseudopapillary neoplasm.

Solid Serous Adenoma of the Pancreas: A Case Report and Review of the Literature

Herein, we report a case of a solid-type serous cystadenoma of the pancreas which is the 16th case reported worldwide and the first ever reported in Greece. Magnetic resonance imaging showed a hypervascular mass in the tail of the pancreas of a 72-year-old female who presented with mild abdominal pain. Distal pancreatectomy was performed by laparotomy and histological and immunohistochemical examination revealed a solid-type serous cystadenoma of the pancreas. Preoperative diagnosis of a solid-type serous cystadenoma of the pancreas is difficult, and, due to its benign nature, simple excision of the tumor is the recommended treatment.

Prevalence, Diagnosis and Management of Pancreatic Cystic Neoplasms: Current Status and Future Directions

Cystic neoplasms of the pancreas are found with increasing prevalence, especially in elderly asymptomatic individuals. Although the overall risk of malignancy is very low, the presence of these pancreatic cysts is associated with a large degree of anxiety and further medical investigation due to concerns about malignancy. This review discusses the different cystic neoplasms of the pancreas and reports diagnostic strategies based on clinical features and imaging data. Surgical and nonsurgical management of the most common cystic neoplasms, based on the recently revised Sendai guidelines, is also discussed, with special reference to intraductal papillary mucinous neoplasm (IPMN; particularly the branch duct variant), which is the lesion most frequently identified incidentally. IPMN pathology, its risk for development into pancreatic ductal adenocarcinoma, the pros and cons of current guidelines for management, and the potential role of endoscopic ultrasound in determining cancer risk are discussed. Finally, surgical treatment, strategies for surveillance of pancreatic cysts, and possible future directions are discussed.

Current perspectives on pancreatic serous cystic neoplasms: Diagnosis, management and beyond

Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomatic and found incidentally. Despite overall low risk of malignancy, these pancreatic cysts still generate anxiety, leading to intensive medical investigations with considerable financial cost to health care systems. This review discusses the general background of serous cystic neoplasms, including epidemiology and clinical characteristics, and provides an updated overview of diagnostic approaches based on clinical features, relevant imaging studies and new findings that are being discovered pertaining to diagnostic evaluation. We also concisely discuss and propose management strategies for better quality of life.

Serous Neoplasms of the Pancreas: A Clinicopathologic Analysis of 193 Cases and Literature Review With New Insights on Macrocystic and Solid Variants and Critical Reappraisal of So-called "Serous Cystadenocarcinoma"

The literature on "variants" and "malignant" counterparts of pancreatic serous cystic neoplasms (SCNs) is highly conflicted. Clinicopathologic characteristics of 193 SCNs were investigated, along with a critical literature review. For the macrocystic (oligocystic) variant, in this largest series, a demographic profile in contrast to current literature was elucidated, with 21% frequency, predominance in female individuals (4:1), body/tail location (1.7×), younger age of patients (mean age, 50 y), and frequent radiologic misdiagnosis as other megacystic neoplasms. Solid SCNs were rare (n=4, 2%) and often misinterpreted radiologically as neuroendocrine tumors. Available fine-needle aspiration in 11 cases was diagnostic in only 1. Radiologic impression was "malignancy" in 5%. Associated secondary tumors were detected in 13% of resections, mostly neuroendocrine. Secondary "infiltration" (direct adhesion/penetration) of spleen, stomach, colon, and/or adjacent nodes was seen in 6 (3%) fairly large SCNs (mean, 11 cm) with no distant metastasis. Three SCNs recurred locally, but completeness of original resection could not be verified. Our only hepatic SCN lacked a concurrent pancreatic tumor. Literature appraisal revealed that there are virtually no deaths that are directly attributable to dissemination/malignant behavior of SCNs, and most cases reported as "malignant" in fact would no longer fulfill the more recent World Health Organization criteria but instead would represent either (1) local adhesion/persistence of tumor, (2) cases with no histologic verification of malignancy, or (3) liver SCNs with benevolent behavior (likely representing multifocality, rather than true metastasis, especially considering there was no fatality related to this and no reported metastases to other remote sites). In conclusion, in contrast to the literature, the clinicopathologic characteristics of solid and macrocystic SCN variants are similar to their microcystic counterpart, although their radiologic diagnosis is challenging. Recurrence/secondary invasion of neighboring organs occurs rarely in larger SCNs but seems innocuous. An SCN should not be classified as "malignant" unless there is clear-cut evidence of histologic malignancy or documented distant metastasis.

Differentiation of solid-type serous cystic neoplasm from neuroendocrine tumour in the pancreas: value of abdominal MRI with diffusion-weighted imaging in comparison with MDCT

AIM

To evaluate the value of abdominal MRI with diffusion-weighted (DW) imaging for differentiation of solid-type serous cystic neoplasm (SCN) from neuroendocrine tumour (NET) in the pancreas compared with that of CT.

MATERIALS AND METHODS

Ten solid-type SCNs and 15 NETs were included in the study. Qualitative and quantitative analyses were performed, and two observers independently reviewed CT and MRI images for diagnosis of solid-type SCNs. Fisher's exact test and Mann-Whitney U-test, diagnostic performance [receiver operating characteristic (ROC) curve analysis] were evaluated.

RESULTS

SCNs showed more frequently hypo-attenuation on unenhanced CT images and marked hyperintensity on T2-weighted images compared with NETs (p < 0.01). The density of the tumour on unenhanced CT images and the apparent diffusion coefficient (ADC) value of the tumour were significantly different between SCNs (mean 18.5 HU; mean 2.45 × 10(-3) mm(2)/s) and NETs (mean 39.2 HU; mean 1.51 × 10(-3) mm(2)/s; p < 0.001). In the differentiation of SCNs from NETs, diagnostic performance of MRI with DW images was significantly higher than that of CT imaging (p < 0.01).

CONCLUSION

Abdominal DW-MRI shows a higher diagnostic accuracy than abdominal CT imaging in the differentiation of solid-type SCNs from NETs.

Characterization of pancreatic serous cystadenoma on dual-phase multidetector computed tomography

OBJECTIVE

The objective of the study was to characterize pancreatic serous cystadenomas on dual-phase multidetector computed tomography in a surgical series.

MATERIALS AND METHODS

This is a retrospective review of preoperative dual-phase multidetector computed tomographic scans from 68 patients with surgically resected and pathologically confirmed pancreatic serous cystadenomas.

RESULTS

Pancreatic serous cystadenomas were most commonly found in the tail (39%). The mean (SD) axial dimension was 4.5 (2.7) cm. A total of 36% contained internal calcifications. Dilatation of the main pancreatic duct (14%) and pancreatic parenchymal atrophy (11%) were uncommon. The mean (SD) attenuation of components with the highest attenuation was 49.1 (35.0) Hounsfield units on the arterial phase and 48.5 (33.4) Hounsfield units on the portal venous phase. Only 20% of neoplasms demonstrated "classic" morphology, as defined by multiple thin nonenhancing septations, calcifications, as well as the absence of main pancreatic duct dilatation and vascular involvement.

CONCLUSIONS

Only 20% of surgically resected serous cystadenomas fulfilled classic morphology. Attenuation was helpful in differentiating serous cystadenomas from insulinomas and other cystic pancreatic masses, but it was not helpful in differentiation from pancreatic adenocarcinomas. Morphologic features were more helpful in differentiating serous cystadenomas from malignant masses.

Primary solid pancreatic tumors: recent imaging findings updates with pathology correlation

The imaging findings of primary solid pancreatic tumors have long been studied and are generally well-established. However, interestingly enough, a wealth of new information has recently appeared in the literature, including the imaging findings of novel or previously seldom-addressed pathological entities as well as atypical imaging findings of common tumors, both of which are well-correlated with the pathology findings. 5 %-14 % of pancreatic ductal adenocarcinomas have been reported on dynamic contrast-enhanced computed tomography to be isoattenuating, and thus making the imaging diagnosis challenging. The imaging-pathology correlation in such isoattenuating tumors is presented along with a discussion regarding the early imaging detection of pancreatic cancers. Colloid (or mucinous non-cystic) pancreatic cancer may resemble a less harmful cystic lesion due to its abundant extracellular mucin, and thus requiring caution in the image interpretation. Serotonin-producing neuroendocrine tumors have recently been recognized as a separate entity from usual neuroendocrine tumors. Exuberant fibrosis caused by serotonin metabolites and scarce tumor cells creates a unique pattern of pancreatic ductal obstruction seen on imaging. Small solid pseudopapillary tumors appear as unencapsulated, completely solid lesions with gradually increasing enhancement after contrast administration, unlike typical solid pseudopapillary neoplasms that present as a large mixed solid and degenerated cystic or hemorrhagic mass encapsulated by a thick capsule and which, therefore, tend to be misdiagnosed on imaging. Solid serous adenoma is a rare, solid variant of serous cystadenoma and appears on imaging as a hypervascular, solid nodule due to its genuinely microscopic cystic, alveolar, and ectatic tubular tumor architecture.

Imaging pitfalls of pancreatic serous cystic neoplasm and its potential mimickers

The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm (SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts (honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm (IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.

Differentiation of branch duct intraductal papillary mucinous neoplasms from serous cystadenomas of the pancreas using contrast-enhanced sonography

OBJECTIVES

The purpose of this study was to determine whether contrast-enhanced sonography can improve the ability to differentiate branch duct intraductal mucinous neoplasms from serous cystadenomas of the pancreas compared to conventional (unenhanced) sonography alone.

METHODS

Between March 2008 and May 2012, there were 20 patients with branch duct intraductal mucinous neoplasms and 25 with serous cystadenomas in our institute, for whom preoperative conventional and contrast-enhanced sonographic results were available. The final diagnosis was obtained by histopathology. Various conventional and contrast-enhanced sonographic characteristics were retrospectively evaluated by 2 radiologists in consensus. A receiver operating characteristic curve analysis was used to evaluate the diagnostic value of conventional and contrast-enhanced sonography for discriminating between the two entities.

RESULTS

Three conventional sonographic characteristics (microcysts, cysts with internal echoes, and main pancreatic duct dilatation) and 2 contrast-enhanced sonographic characteristics (communication between the lesion and main pancreatic duct and enhancement of mural nodules) significantly improved the ability to differentiate branch duct intraductal mucinous neoplasms from serous cystadenomas. The area under the receiver operating characteristic curve increased from 0.691 with conventional sonography to 0.859 with combined contrast-enhanced and conventional ultrasonography (P = .043).

CONCLUSIONS

In this series of patients, the addition of contrast-enhanced sonography to conventional sonography improved the ability to differentiate branch duct intraductal mucinous neoplasms from serous cystadenomas.

Diagnostic value of ultrasound in detection of solid pseudopapillary tumor of the pancreas

AIM: To investigate the diagnostic value of ultrasound in the detection of solid pseudopapillary tumor of the pancreas (SPTs).

METHODS: The data of ultrasound and contrast-enhanced ultrasound for 30 patients with pathologically confirmed SPTs were retrospectively analyzed. The rates of detection of SPTs by the two methods were compared using the χ² test or Fisher's exact test.

RESULTS: Of 30 patients, 1 was male and the others were female. Their mean age was 30.5 years, ranging from 13 to 58 years. Fourteen tumors were located in the head of the pancreas, 4 in the body of the pancreas and 12 in the tail of the pancreas. The size of tumors ranged from 1.5 cm × 1.1 cm × 1.8 cm to 21 cm × 11 cm × 15 cm. Of 26 cases examined by ultrasound, 17 were correctly diagnosed, 1 had missed diagnosis, and 8 were diagnosed with other tumors of the pancreas. Of 4 cases examined by contrast-enhanced ultrasonography, 3 were correctly diagnosed and 1 was diagnosed with other tumor of the pancreas. There was no significant difference in the diagnostic accuracy between the two methods (64% vs 75%, P = 0.593).

CONCLUSION: SPTs exhibit some special ultrasound features, which may be helpful to diagnose this type of tumor.