To date, more than 700 cases of SPTs have been reported in English literature. About 15% are known to present metastasis or recurrence. However, based on the conventional histopathology, it has been difficult to establish the criteria which could be suggestive of the aggressive behavior including recurrence and metastasis. It is well-known that MDCT can provide more accurate delineation of normal and abnormal pancreatic morphology. There is no published literature regarding the imaging features implying the malignant potential of the SPTs of pancreas on MDCT.
A clinical research article to be published on February 21, 2009 in the World Journal of Gastroenterology address this question. The research team led by Prof. Wang DB from Ruijin Hospital of Shanghai Jiao Tong University School of Medicine used the sophisticated MDCT, which is broadly applied in clinical practice for detection and characterization of pancreatic abnormalities. The research further investigates the imaging features of SPTs of the pancreas on MDCT and defines the imaging findings suggestive of the malignant potential associated with aggressive behaviors.
When the size of the tumor was greater than 6 cm (including 6 cm), the possibilities of vascular (8 vs 1) and capsular invasion (9 vs 0) increased significantly (P< 0.05). Two pathologically benign cases with vascular invasion and disrupted capsule on MDCT presented with local recurrence and hepatic metastases during follow-up about one year post resection of the primary tumors. Therefore, vascular and capsular invasion with superimposed spread into the adjacent pancreatic parenchyma and nearby structures in SPTs of the pancreas could be accurately revealed by MDCT preoperatively.
These imaging findings could be predictive of the malignant potential associated with the aggressive behaviors of the tumor, even in the pathologically benign cases. It seems that the imaging findings are probably beneficial to patient's surgical protocol planning. It is suggested that more aggressive surgery be needed for the patients with imaging findings implying malignant potential at MDCT.