A Patient with a 10-mm Solid Pseudopapillary Neoplasm of the Pancreas in whom Contrast-enhanced Endoscopic Ultrasonography was Useful for Diagnosis

Abstract

The patient was a 46-year-old woman. CT and MRI revealed a mass, 10-mm in diameter, located in the uncinate process of the pancreas. The qualitative diagnosis was difficult. On contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) , a papillary solid region in the tumor showed contrast enhancement similar to that of the surrounding normal pancreatic parenchyma in the early phase. The contrast with an anechoic region was clearly depicted. A solid pseudopapillary neoplasm of the pancreas (SPN) was suspected, and a pylorus-preserving pancreatoduodenectomy was performed. The pathological diagnosis including the results of immunohistochemistry was an SPN. Even if the tumor diameter is small, CH-EUS can provide an evaluation of blood flow and clearer contrast on opacified images and is therefore considered a useful diagnostic modality.