Clinical details : 30 yrs old female patient presented with lump in abdomen.

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Legend: image 2,3 show a well defined heterogenous lesion noted involving head of pancreas with few cystic spaces within and increased vascularity.

Discussion:
Solid pseudopapillary tumour is an uncommon benign exocrine pancreatic tumour . these comprise 9 % of pancreatic cystic tumours , may be asympotomatic or may present as gradually enlarging nontender abdominal mass ,vague abdominal pain , discomfort or obstructive symptoms.
Although most solid pseudopapillary tumours exibit benign behviour , malignant degeneration, invasion of adjacent structures and matastasis can occur.
These malignant tumours are usually seen in older individuals and have mal predilection .they are designated as pseudopapillary carcinomas.
The most common site of metastasis is the liver , and the metastasis exhibits complex feaures similar to the primary lesion.
Rarely lymphnode metastasis, peritoneal sread and multiplicity can occur. Invasion of the capsule and surrounding stuctures can occur.

Pathology:
These lesions are well encapsulated with varyig amounts of necrosis , hemorrhage and cystic changes . both the capsule and intrarumoral haemorrhage are important clue to diagnosis because these fetures are arely ound in other tumours.

Age:
Patients are affected between 2nd and 3rd decade of life.

Sex:
Females are more commonly affected than males.

Imaging:

Ultrasound:
Well encapsulated solid-cystic lesion . the cystic areas are a result of hemorrhagic degeneration within the solid components.

CT:
Heterogenous well encapsulated lesion with varying solid and cystic components owing to hemorrhagic degeneration . following contrast administration ,enhancing solid areas are typically located peripherally ,whereas cstic spaces are more centrally located .

MRI:
Well defined lesion with heterogenous signal intensity on T1 and T2 weighted images , which reflects a complex nature of the mass.T2 weigted images show a thick fibrous capsule which is seen as a rim of low signal intensity.SPT can be differentiated from islet cell tumour by presence of a hemorrhagic component that has high signal intensity on T1 weighted images and low signal intensity on T2 weighted images .

Management:
Benign solid pseudopapillary tumour is treated with surgery and complete resection is usually curative.

References:
Buetow PC, Buck JL, Pantongrag-Brown L, Beck KG, Ros PR, Adair CF: Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation in 56 cases. Radiology, 1996, 199: 707-711.
Dong PR, Lu DSK, Degregario F, Fell SC, Au A, Kadell BM: Solid and papillary neoplasm of the pancreas: radiological-pathological study of five cases and review of the literature. Clin Radiol, 1996, 51: 701-705.
Mergo PJ, Helmberger TK, Buetow PC, Helmberger RC, Ros PR: Pancreatic neoplasms: MR Imaging and pathologic correlation. Radiographics, 1997, 17: 281-301.
Choi BI, Kim KW, Han MC, Kim YI, Kim CW: Solid and papillary epithelial neoplasms of the pancreas: CT findings.Radiology, 1988, 166: 413-416.

Contributed by:
Dr. Dhakate
Dr. Chhad
Dr. Aditi waikar
Dr Chetan Jathar
Dr. Atul
Dr. Sharmishtha
Dr. Sunita