Advertisement

Der Radiologe

, Volume 48, Issue 8, pp 764–769 | Cite as

Solide pseudopapilläre Tumoren des Pankreas

Häufig vergessen
  • K.A. HerrmannEmail author
  • T. Helmberger
  • C. Bruns
  • M.F. Reiser
  • C.J. Zech
Leitthema

Zusammenfassung

Solide pseudopapilläre Tumoren des Pankreas (SPTP) sind seltene Entitäten mit niedrigem Malignitätsgrad, die überwiegend bei jungen Frauen auftreten, typischerweise aus soliden, zystischen und zentral hämorrhagischen Komponenten bestehen und eine sehr gute Prognose haben.

In der bildgebenden Diagnostik stellen sie sich relativ charakteristisch dar: rund bis ovalär, glatt begrenzt mit einer fibrotischen Pseudokapsel, die das meist gemischt solide und zystisch-hämorrhagische Tumorgewebe umgibt. Nach Kontrastmittelgabe zeigen SPTP eine protrahierte randständige Kontrastmittelaufnahme. Kalzifikationen können im Randbereich des Tumors vorkommen. Die MRT ist der CT bei der Diagnostik der hämorrhagischen Veränderungen überlegen.

Das Bewusstsein und die Kenntnis der SPTP bei Radiologen und Chirurgen ist eine der wichtigsten Voraussetzungen für die korrekte Diagnose dieser seltenen Tumorentität mit exzellenter Prognose nach chirurgischer Therapie.

Schlüsselwörter

Solide pseudopapilläre Tumoren Diagnostische Herausforderung Magnetresonanztomographie (MRT) Chirurgische Therapie Prognose 

Solid pseudopapillary pancreas tumors

Often neglected

Abstract

Solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors of the pancreas with low malignancy potential and a very good prognostic outcome after surgery. They typically occur in young women or adolescents and consist of solid, cystic and cystic-hemorrhagic components.

Imaging findings in these tumors are characteristic and include a fibrotic capsule with a clear delineation and exhibit solid and cystic-hemorrhagic signal and density characteristics. Calcifications may be present in the periphery of the tumor. The tumor capsule shows contrast enhancement, the solid components in the periphery enhance in the early phase and gradually and inhomogeneously in late phases. MRI is superior to CT and other imaging modalities for characterization of SPTP. Awareness and knowledge of this tumor entity with an excellent prognosis is crucial to guide the patient towards effective, predominantly organ-sparing surgical treatment.

Keywords

Solid pseudopapillary tumors Diagnostic challenge Magnetic resonance imaging (MRI) Surgical therapy Prognosis 

Notes

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Buetow PC, Miller DL, Parrino TV, Buck JL (1997) Islet cell tumors of the pancreas: clinical, radiologic and pathologic correlation in diagnosis and localization. Radiographics 17(2): 453–472PubMedGoogle Scholar
  2. 2.
    Cantisani V, Mortele KJ, Levy A et al. (2003) MR imaging features of solid pseudopapillary tumor of the pancreas in adult and pediatric patients. AJR Am J Roentgenol 181(2): 395–401PubMedGoogle Scholar
  3. 3.
    Choi SH, Kim SM, Oh JT et al. (2006) Solid pseudopapillary tumor of the pancreas: a multicenter study of 23 pediatric cases. J Pediatr Surg 41(12): 1992–1995PubMedCrossRefGoogle Scholar
  4. 4.
    Dong DJ, Zhang SZ (2006) Solid-pseudopapillary tumor of the pancreas: CT and MRI features of 3 cases. Hepatobiliary Pancreat Dis Int 5(2): 300–304PubMedGoogle Scholar
  5. 5.
    Frantz VK (1959) Tumors of the pancreas. atlas of tumor pathology section VH, fascicles 27 and 28. Washington DC, US Armed Forces Institute of PathologyGoogle Scholar
  6. 6.
    Huang HL, Shih SC, Chang WH et al. (2005) Solid-pseudopapillary tumor of the pancreas: clinical experience and literature review. World J Gastroenterol 7 11(9): 1403–1409Google Scholar
  7. 7.
    Jani N, Dewitt J, Eloubeidi M et al. (2008) Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: a multicenter experience. Endoscopy 40(3): 200–203; Epub 2007 Dec 7PubMedCrossRefGoogle Scholar
  8. 8.
    Klöppel G, Maurer R, Hofmann E et al (1991) Sold-cystic (papillary-cystic) tumorus within and outside the pancreas in men: report of two patients. Virchows Arch 418: 179–181CrossRefGoogle Scholar
  9. 9.
    Kosmahl M, Peters K, Anlauf M et al. (2005) Solid pseudopapillary neoplasms. Enigmatic entity with female preponderance. Pathologe 26(1): 41–45PubMedCrossRefGoogle Scholar
  10. 10.
    Lee DH, Yi BH, Lim JW, Ko YT (2001) Sonographic findings of solid and papillary epithelial neoplasms of the pancreas. J Ultrasound Med 20: 1229–1232PubMedGoogle Scholar
  11. 11.
    Lee JK, Tyun YS (2005) Detection of a solid pseudopapillary tumor of the pancreas with F-18-FDG positron emission tomography. Clin Nucl Med 30: 187–188PubMedCrossRefGoogle Scholar
  12. 12.
    Machado MC, Machado MA, Bacchella T et al. (2008) Solid pseudopapillary neoplasm of the pancreas: distinct patterns of onset, diagnosis, and prognosis for male versus female patients. Surgery 143(1): 29–34; Epub 2007 Nov 5PubMedCrossRefGoogle Scholar
  13. 13.
    Mao C, Guvendi M, Domenico DR et al. (1995) Papillary cystic and solid tumors of the pancreas: a pancreatic embryonic tumor? Studies of three cases and cumulative review of the world’s literature. Surgery 118: 821–828PubMedCrossRefGoogle Scholar
  14. 14.
    Nishihara K, Nogoshi M, Rsuneyoshi M et al. (1993) Papillary cystic tumors of the pancreas: assessment of their malignant potential. Cancer 71: 82–92PubMedCrossRefGoogle Scholar
  15. 15.
    Othomo K, Furui S, Onoue M et al. (1992) Solid and papillary epithelial neoplasm of the pancreas: MR imaging and pathologic correlation. Radiology 184: 567–570Google Scholar
  16. 16.
    Papavramidis T, Papavramidis S (2005) Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in english literature. J Am Coll Surg 200: 965–972PubMedCrossRefGoogle Scholar
  17. 17.
    Pasquiou C, Scoazec JY, Gentil-Perret A et al. (1999) Solid pseudopapillary tumors of the pancreas. Pathology report of 13 cases. Gastroenterol Clin Biol 23(2): 207–214PubMedGoogle Scholar
  18. 18.
    Rebhandl W, Felberbauer FX, Puig S et al. (2001) Solid-pseudopapillary tumor of the pancreas (frantz tumor) in children: report of four cases and review of the literature. J Surg Oncol 76: 289–296PubMedCrossRefGoogle Scholar
  19. 19.
    Salvia R, Bassi C, Festa L et al. (2007) Clinical and biologiecal behaviour of pancreatic solid pseuodpapillary tumors: report on 31 consecutive patients. J Surg Ocol 95: 304–310CrossRefGoogle Scholar
  20. 20.
    Solcia E, Capella C, Klöppel G (1997) Tumors of the pancreas. AFIP atlas of tumor pathology, 3rd series, fascicle 20. Armed Forces Institute of Pathology, Washington DCGoogle Scholar
  21. 21.
    Sun CD, Lee WJ, Choi JS et al. (2005) Solid-pseudopapillary tumours of the pancreas: 14 years experience. ANZ J Surg 75(8): 684–689PubMedCrossRefGoogle Scholar
  22. 22.
    Yamaguchi K, Hirakata R, Kitamura K (1990) Papillary cystic neoplasm of the pancreas: radiological and pathological characteristics in 11 cases. Br J Surg 77: 1000–1003PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  • K.A. Herrmann
    • 1
    Email author
  • T. Helmberger
    • 2
  • C. Bruns
    • 3
  • M.F. Reiser
    • 1
  • C.J. Zech
    • 1
  1. 1.Institut für Klinische RadiologieKlinikum Großhadern der Ludwig-Maximilians-Universität München MünchenDeutschland
  2. 2.Institut für Diagnostische und Interventionelle Radiologie und Nuklearmedizin Klinikum Bogenhausen, Städt. Klinikum MünchenMünchenDeutschland
  3. 3.Klinik und Poliklinik für ChirurgieKlinikum Großhadern der Ludwig-Maximilians-Universität München MünchenDeutschland

Personalised recommendations