Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

LETTER TO EDITOR
Year
: 1999  |  Volume : 9  |  Issue : 1  |  Page : 37--38

Solid and papillary epithelial neoplasm of the pancreas


Pratibha Issar1, SK Issar2, R Prasad2, MK Dwivedi1,  
1 Department of Radiodiagnosis, Jawaharlal Nehru Hospital & Research Centre, Bhilai, India
2 Department of Gastroenterology, Jawaharlal Nehru Hospital & Research Centre, Bhilai, India

Correspondence Address:
Pratibha Issar
Department of Radiodiagnosis, Jawaharlal Nehru Hospital & Research Centre, Bhilai
India




How to cite this article:
Issar P, Issar S K, Prasad R, Dwivedi M K. Solid and papillary epithelial neoplasm of the pancreas.Indian J Radiol Imaging 1999;9:37-38


How to cite this URL:
Issar P, Issar S K, Prasad R, Dwivedi M K. Solid and papillary epithelial neoplasm of the pancreas. Indian J Radiol Imaging [serial online] 1999 [cited 2020 Nov 28 ];9:37-38
Available from: https://www.ijri.org/text.asp?1999/9/1/37/28375


Full Text

Sir,

We wish to submit an interesting case of a solid and papillary epithelial neoplasm (SPNP) of the pancreas. A thirty-five years old woman presented with a lump in the left upper abdomen of two months duration.

Abdominal examination revealed a non-tender firm lump with a smooth surface in the left hypochondrium. Laboratory values were unremarkable. US showed a circumscribed, mixed echogenic mass anterolateral to the tail of the pancreas [Figure 1]. CT of the abdomen revealed an encapsulated hypodense mass measuring 7.9 x 7.6 x 8.2 cm anterolateral to the tail of the pancreas, with obliteration of fat planes between the mass and pancreatic tail region. A post-contrast study revealed heterogeneous enhancement with areas of necrosis [Figure 2].

On laparotomy, an encapsulated mass was found attached to the tail of the pancreas and was removed with the adherent pancreatic tail. No metastatic spread was noticed. On histopathological examination, it was found to be an SPNP.

SPNP is an uncommon pancreatic neoplasm. Its pre-operative recognition is important because excision of the tumor leads to excellent prognosis. Ultrasound and CT demonstrate encapsulated, large pancreatic masses that are frequently seen in the tail region. The architecture of the mass varies from solid, homogeneous muscle density, mixed solid and cystic, to thick-walled cysts, depending on the degree of hemorrhage and/or necrosis. Rarely, punctate calcification is seen at the periphery [1],[3]. T1W MR images show areas of high signal intensity distributed diffusely, secondary to hemorrhage. Very rarely, metastatic spread of the tumor is noticed in the liver and lymph nodes, having appearances similar to the primary mass [1],[2]. Differential diagnosis includes ductal cell adenocarcinoma, microcystic adenoma, mucinous cystic neoplasm, non-functioning islet cell tumor, pancreatoblastoma and calcified hemorrhagic pseudocyst. Although the imaging findings of SPNP are not specific, they are highly suggestive in an appropriate clinical setting. When CT shows the characteristic finding of a sharply demarcated large mass with solid and cystic areas mainly situated in the pancreatic tail region in young women, this rare tumor entity should be the primary diagnostic consideration[4].

References

1Friedman A., Lichtenstein J. Solid and Papillary Epithelial Neoplasm of the Pancreas. Radiology 1985; 154: 333-337.
2Byung Ihn Choi, Kiwhang Kim. Solid and Papillary Epithelial Neoplasm of the Pancreas: CT findings. Radiology 1988; 166: 413-416.
3Peter C.Buctow, James L.Buck. Solid and Papillary Epithelial Neoplasm of the pancreas. Imaging - Pathologic Correlation in 56 cases. Radiology 1996; 199: 707-711.
4Savci G, Kilicturgay S. Solid and Papillary Epithelial Neoplasm of the Pancreas. CT and MR findings. Eur Radiol 1996; 6: 86-88.