対照的な画像所見を呈した膵 Solid-pseudopapillary neoplasm の2例

A solid pseudo-papillary tumor of the pancreas is a rare neoplasm which mainly occurs in young women. Here, we report two cases of solid-pseudopapillary neoplasm of the pancreas (SPN) with contrasting imaging findings. One was a 59-year-old woman having no symptomatic complaint with a pancreatic cystic tumor in the tail. The tumor was 60 mm in diameter with a cyst composed of a calcified wall and low-density content which was poorly perfused on contrast-enhanced computed tomography (CT). We diagnosed SPN based on imaging findings and performed distal pancreatectomy. Histology revealed SPN, and the patient had two years of recurrence -free survival (RFS). The other case was a 34-year-old man with an asymptomatic solid tumor in the pancreatic tail. Contrast-enhanced CT showed low peripheral attenuation of a 25-mm solid tumor, with the main duct dilated distal from tumor. We diagnosed him with pancreatic cancer with atypical image findings. Pathological findings revealed SPN, and the patient had five years of RFS. Small-sized SPN is being increasingly recognized because of the recent advances in CT and MRI. We should consider SPN even if it occurs in a male, and endoscopic ultrasound -guided fine-needle aspiration has recently been reported to be useful in diagnosing SPN.

症例報告（Case Report）