Review of Pancreatic Masses in Children

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  • Ohkura Takahiro
    Department of Pediatric Surgery, National Hospital Organization Okayama Medical Center Chugoku-Shikoku Pediatric Surgical Partners Organization
  • Nakahara Yasuo
    Department of Pediatric Surgery, National Hospital Organization Okayama Medical Center Chugoku-Shikoku Pediatric Surgical Partners Organization
  • Akiyama Takashi
    Chugoku-Shikoku Pediatric Surgical Partners Organization Department of Pediatric Surgery, Hiroshima City Hospital Department of Pediatric Surgery, Chuden Hospital
  • Kawasaki Masahiro
    Chugoku-Shikoku Pediatric Surgical Partners Organization Department of Pediatric Surgery, Yamaguchi Grand Medical Center
  • Iwamura Yoshinobu
    Chugoku-Shikoku Pediatric Surgical Partners Organization Department of Pediatric Surgery, National Hospital Organization Shikoku Medical Center for Children and Adults
  • Kumori Takashi
    Chugoku-Shikoku Pediatric Surgical Partners Organization Department of Digestive and General Surgery, Shimane University Hospital
  • Takao Tomoya
    Chugoku-Shikoku Pediatric Surgical Partners Organization Department of Pediatric Surgery, Himeji St. Mary’s Hospital
  • Katayama Shuichi
    Chugoku-Shikoku Pediatric Surgical Partners Organization Department of Pediatric Surgery and General Surgery, Kurashiki Central Hospital
  • Goto Takafumi
    Department of Pediatric Surgery, National Hospital Organization Okayama Medical Center Chugoku-Shikoku Pediatric Surgical Partners Organization
  • Aoyama Koji
    Department of Pediatric Surgery, National Hospital Organization Okayama Medical Center Chugoku-Shikoku Pediatric Surgical Partners Organization

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Other Title
  • 小児膵腫瘤性病変の検討
  • ショウニスイシュリュウセイ ビョウヘン ノ ケントウ

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Description

<p>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.</p><p>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.</p><p>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.</p><p>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.</p>

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