2019 Volume 55 Issue 4 Pages 802-808
Purpose: Pancreatic masses are rare in children. We studied the clinical presentation and imaging findings to establish a differential diagnosis of pancreatic masses in children.
Methods: We reviewed the medical records of children diagnosed as having pancreatic masses on the basis of ultrasonography (including antenatal ultrasonography), computed tomography (CT), or magnetic resonance imaging findings across 7 hospitals between April 2005 and March 2017. We analyzed symptoms, imaging findings, treatment administered, and prognosis.
Results: Of the 17 children enrolled in this study, 5 were diagnosed as having SPN and 5 as having acute peripancreatic fluid collection/pancreatic pseudocyst (APFC/PPC). Pancreatic teratoma, acinic cell carcinoma, insulinoma, metastatic pancreatic tumor, and an intrapancreatic accessory spleen were diagnosed in 1 child each. On the basis of imaging findings, 2 lesions were diagnosed as congenital true pancreatic cysts. The masses were symptomatic in eleven cases. Six masses were detected through imaging studies for abdominal trauma. Dynamic CT of the pancreas revealed gradually increasing contrast enhancement in 3 children with SPN. Of the 5 children diagnosed as having SPN, we were unable to identify the tumor capsule in 2 children, and calcification (a characteristic finding in SPN) was observed in 4 children.
Conclusions: Pancreatic masses in children include benign and malignant tumors; however, most tumors identified in our case series were SPN and APFC/PPC. Imaging studies performed to diagnose SPN in children did not necessarily reveal the characteristic findings of SPN. However, the gradually increasing contrast enhancement observed on dynamic CT would be a useful diagnostic modality.
