October Case of the Month
Authors: Matthew Locke Kendrick, MD, PGY-4/R3, Radiology Resident, Diagnostic Radiology,Department of Radiology, and Jeffrey Brandon, MD, FACR, Professor of Radiology, Diagnostic Radiology, Department of Radiology
Institution: University of South Alabama Health System, Mobile, Ala.
Why did you select this case for submission?
Case in Point has been a valuable resource throughout my training, and I wished to contribute so that others could benefit from this interesting case. This case prompted review of a more common differential but also highlights some less commonly known concepts, given its unusual nature.
A review of prior Case in Point publications showed one case submission of a solid pseudopapillary tumor, which demonstrated only CT and ultrasound images. Our case demonstrates correlation of classic findings across the three most common imaging modalities.
What should readers learn from this case?
The most important teaching point from this case is the differential for pancreatic tail masses. This case also demonstrates typical imaging findings for the uncommon pancreatic tumor. Suspicion for solid pseudopapillary tumor should warrant careful inspection of the liver, given it is the most common site of metastasis. Preoperative detection is important for treatment planning.
What did you learn from working on the case?
This case was a great opportunity to review pancreatic masses. In particular, it was a great example of the heterogeneous signal and dark fibrous capsule, which is typical of these masses. Also, I did not know that as many as 15% of solid pseudopapillary tumors may be malignant.
What is the appeal of online learning tools such as Case in Point as opposed to print learning venues?
Online learning is readily available and easy to access at home or even during a down moment at the workstation. These cases are also quick to review and provide flexibility to fit into a busy schedule. They also remain available to access as a reference when a similar case in encountered in practice.
Are you a regular reader of Case in Point? What are your favorite types of cases?
Yes, I regularly read Case in Point and have found that it provides a means for constant daily challenge and self-learning. I enjoy cases that demonstrate an uncommon diagnosis that is a part of a more commonly used differential.