Differentiation of Benign and Malignant Solid Pseudopapillary Neoplasms of the Pancreas

Objective: The aim of this study was to investigate differential imaging features between benign and malignant solid pseudopapillary neoplasms (SPN) of the pancreas on computed tomographic and magnetic resonance imagings. Methods: Between January 2001 and January 2007, we identified 30 patients with confirmed SPN by surgery. The computed tomographic and magnetic resonance images were reviewed by 3 radiologists in consensus. Each tumor was analyzed for the following categories: location of tumor, tumor margin, proportion of solid component, morphology of capsule, growth pattern, calcification, and presence of upstream pancreatic ductal dilatation. Results: Benign SPN usually had oval/round or smoothly lobulated margins, and malignant SPN more commonly had focal lobulated margins (P = 0.027). Presence of complete encapsulation was more frequently seen in benign SPN, whereas focal discontinuity of capsule was more commonly seen in malignant SPN (P = 0.005). There was no statistical difference between benign and malignant tumors in other imaging findings. Conclusions: A focal lobulated margin and a focal discontinuity of the capsule may suggest malignant SPN, whereas a round or smoothly lobulated margin and a complete encapsulation were more commonly seen in benign SPN.