Question:

Regarding the diagnosis of solid pseudopapillary tumor (SPT), which of the following is false?
1. Differential diagnosis should include a pancreatic pseudocyst.
2. Differential diagnosis should include a non-functioning islet cell tumor.
3. Atypical SPT should be differentiated from pancreatic adenocarcinoma.
4. The presence of a capsule helps radiologist in the differential diagnosis between SPT and non-functioning islet cell tumor.
5. Fine-needle aspiration is indicated for unresectable solid-pseudopapillary lesions.





Answer:

The correct answer for the question "Regarding the diagnosis of solid pseudopapillary tumor (SPT), which of the following is false?" is:

4. The presence of a capsule helps radiologist in the differential diagnosis between SPT and non-functioning islet cell tumor.



Explanation
1. Differential diagnosis should include a pancreatic pseudocyst. (Pancreatic pseudocysts can present peripheral calcifications and hemorrhagic areas [13]; in these cases it may be difficult to make a differential diagnosis.)

2. Differential diagnosis should include a non-functioning islet cell tumor. (These lesions are similar because they are well-defined and have a cystic appearance, limited by a continuous capsule [6].)

3. Atypical SPT tumor should be differentiated from pancreatic adenocarcinoma. (In atypical appearance of SPT, a differential diagnosis from ductal adenocarcinoma is called for. It is important to remember that adenocarcinoma is more frequently observed in male adults and that at the time of presentation it is small in size.)

4. The presence of a capsule helps radiologist in the differential diagnosis between SPT and non-functioning islet cell tumor. "applies" (This is false, because non-functioning islet cell tumors have a cystic appearance, and are limited by a continuous capsule too.)

5. Fine-needle aspiration is indicated for unresectable solid-pseudopapillary lesions. (Because the risk of seeding of neoplastic cells is possibile, fine-needle aspiration in well defined tumors is indicated for unresectable lesions.)



From the manuscript:
Rare pancreatic neoplasm: MDCT and MRI features of a typical Solid Pseudopapillary Tumor
Radiology Case. 2012 Jan; 6(1):17-24


This article belongs to the GI section.




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From the manuscript

Rare pancreatic neoplasm: MDCT and MRI features of a typical Solid Pseudopapillary Tumor

Free full text article: Rare pancreatic neoplasm: MDCT and MRI features of a typical Solid Pseudopapillary Tumor

Abstract
Solid pseudopapillary tumor of the pancreas is a rare neoplasm, predominantly observed in young women and with greatest incidence in the second and third decade. It has clinically good behavior, although large at the time of diagnosis. We report the case of a thirty-year-old woman with a giant mass in the pancreas, incidentally discovered during an abdominal ultrasonography. The mass was later investigated by multidetector computed tomography and magnetic resonance imaging. The cystic-solid appearance of the encapsulated lesion suggested to radiologists the possibility of a solid pseudopapillary tumor. Imaging features of this pancreatic neoplasm and differential diagnosis from other cystic pancreatic tumors are discussed in our report, in order to help radiologists and clinicians achieve correct diagnosis and management.






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