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  • Title: Computed tomography and magnetic resonance imaging findings of malignant solid pseudopapillary tumors of the pancreas with macroscopic venous tumor thrombosis: a report of 4 cases.
    Author: Liu QY, Lai DM, Zeng YP, Lin XF, Li HG.
    Journal: J Comput Assist Tomogr; 2014; 38(3):383-90. PubMed ID: 24651747.
    Abstract:
    PURPOSE: The purpose of this study was to report the imaging findings of malignant pancreatic solid pseudopapillary tumors (SPTs) with macroscopic venous tumor thrombi. METHODS: The clinical features and imaging findings of 4 cases of malignant pancreatic SPT with venous tumor thrombi were retrospectively reviewed. RESULTS: The tumor thrombi were located in the splenic vein (n = 3) or the main portal vein and the proximal splenic vein (n = 1). Venous thrombi were connected with the main pancreatic tumors and showed venous filling defects on computed tomography and magnetic resonance imaging. Tumor thrombi primarily consisting of necrotic component and/or hemorrhage displayed no enhancement after contrast injection (n = 3). The enhancement pattern of the tumor thrombi that consisted mainly of tumor nests was consistent with pancreatic SPT (n = 1), that is, a slight enhancement in the arterial phase and a progressive enhancement in the portal venous phase and the equilibrium phase. Venous tumor thrombi associated with hemorrhage were hyperintense on both T1-weighted and T2-weighted images. CONCLUSIONS: It is uncommon for pancreatic SPTs to spread by invading the venous system and forming macroscopic venous tumor thrombi.
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