To date, more than 700 cases of SPTs have been reported in English literature. About 15% are known to present metastasis or recurrence. However, based on the conventional histopathology, it has been difficult to establish the criteria which could be suggestive of the aggressive behavior including recurrence and metastasis. It is well-known that MDCT can provide more accurate delineation of normal and abnormal pancreatic morphology. There is no published literature regarding the imaging features implying the malignant potential of the SPTs of pancreas on MDCT.
A clinical research article to be published on February 21, 2009 in the World Journal of Gastroenterology address this question. The research team led by Prof. Wang DB from Ruijin Hospital of Shanghai Jiao Tong University School of Medicine used the sophisticated MDCT, which is broadly applied in clinical practice for detection and characterization of pancreatic abnormalities. The research further investigates the imaging features of SPTs of the pancreas on MDCT and defines the imaging findings suggestive of the malignant potential associated with aggressive behaviors.
When the size of the tumor was greater than 6 cm (including 6 cm), the possibilities of vascular (8 vs 1) and capsular invasion (9 vs 0) increased significantly (P< 0.05). Two pathologically benign cases with vascular invasion and disrupted capsule on MDCT presented with local recurrence and hepatic metastases during follow-up about one year post resection of the primary tumors. Therefore, vascular and capsular invasion with superimposed spread into the adjacent pancreatic parenchyma and nearby structures in SPTs of the pancreas could be accurately revealed by MDCT preoperatively.
These imaging findings could be predictive of the malignant potential associated with the aggressive behaviors of the tumor, even in the pathologically benign cases. It seems that the imaging findings are probably beneficial to patient's surgical protocol planning. It is suggested that more aggressive surgery be needed for the patients with imaging findings implying malignant potential at MDCT.
Reference: Wang DB, Wang QB, Chai WM, Chen KM, Deng XX. Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography. World J Gastroenterol 2009; 15(7): 829-835
http://www.wjgnet.com/1007-9327/15/829.asp
Correspondence to: Deng-Bin Wang, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, 197 Ruijin Er Road, Shanghai 200025, China. dbwang8@yahoo.com.cn
Telephone: +86-21-64370045-665724 Fax: +86-21-64333548
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology