Pancreatic Tumors in Children: Radiologic-Pathologic Correlation

Abstract

Pancreatic neoplasms are rare in children and have a different histologic spectrum and prognosis than those in adults. In general, these tumors are well demarcated with expansile rather than infiltrating growth patterns. They may be quite large at diagnosis, and central cystic necrosis is common. They infrequently cause biliary duct obstruction. The imaging appearance of each neoplasm reflects its pathologic features. Pancreatoblastoma is the most common pancreatic neoplasm in young children. At imaging, pancreatoblastomas are heterogeneous and often multilocular with hyperechoic and enhancing septa. Solid-pseudopapillary tumor occurs in adolescent girls. It is heterogeneous in internal architecture, with a mixture of solid and cystic hemorrhagic and necrotic elements. This tumor is distinguished by its fibrous capsule and hemorrhagic nature, which are best shown at magnetic resonance imaging as a dark rim on T1- or T2-weighted images and hyper-intense foci on T1-weighted images, respectively. Islet cell tumors in children are insulinomas or gastrinomas. These tumors manifest early due to hormonal syndromes and are distinguished by their small size, homogeneous appearance, and intense enhancement with intravenous contrast material. All pancreatic neoplasms in children are capable of producing metastases, usually to the liver and lymph nodes; however, on the whole, these tumors have a better clinical outcome than most pancreatic tumors in adults. Knowledge of the differential diagnosis of pancreatic masses in children and their relatively good prognosis may promote correct preoperative diagnosis and appropriate treatment.

Unusual presentation of a pancreatic mass in an infant: pancreatic haemangioendotheliomatosis

“…The other differential diagnosis considered was a pancreaticoblastoma, given the large size and the peripancreatic extension. However, pancreaticoblastomas are heterogeneous in appearance on imaging and have both cystic and solid components [8]. They can also be multiloculated with enhancing septations, and demonstrate calcification: findings not seen in this case.…”

Hematoma crónico de páncreas. Diagnóstico diferencial con tumos maligno. Informe de un caso

“…El antecedente lejano de traumatismo, el género, edad y cuadro clínico, así como las características tomográficas, en este caso, desviaron la atención hacia la posibilidad de B A Hematoma crónico de páncreas una neoplasia benigna. En la paciente se sospechó tumor seudopapilar de páncreas o tumor Gruder-Frantz, raro, de bajo potencial maligno que ocupa el 6% de los tumores exocrinos del páncreas, y 5% de las neoplasias quísticas del páncreas, ocurre casi exclusivamente en niñas adolescentes y debe diferenciarse de otras patologías pancreáticas como seudoquistes 8 . Se presentan como una tumoración abdominal dolorosa, su apariencia en estudios de imagen es característica, como una masa bien encapsulada, con áreas de calcificación y degeneración hemorrágica así como cambios quísticos degenerativos 9 .…”

Solid pseudopapillary neoplasm of pancreas: a rare presentation

“…2 Pancreatic neoplasms are divided into epithelial and nonepithelial types.  Lymphoma, particularly Burkitt  Sarcomas, particularly rhabdomyosarcoma  Dermoid cyst  Lymphangioma  Hemangioendothelioma First described by Franz in 1959, SPT of the pancreas is a rare, low-grade malignant tumor of unknown etiology accounting for 0.2-2.7% of all primary pancreatic tumors.…”