Macroscopy

The neoplasms present as large, round, solitary masses (average size 8-10 cm; range, 3-18 cm), and are often fluctuant. They are usually encapsulated and well demarcated from the surrounding pancreas. Multiple tumours are exceptional {1427}. The cut surfaces reveal lobulat-ed, light brown solid areas, zones of haemorrhage and necrosis, and cystic spaces filled with necrotic debris. Occasionally, the haemorrhagic-cystic changes involve almost the entire lesion so that the neoplasm may be mistaken for a pseudocyst. The tumour wall may contain calcifications {1358}. A few tumours have been found to be attached to the pancreas or even in extrapancre-atic locations {812, 914, 945}. Invasion of adjacent organs or the portal vein is rare {1655, 1684, 1701}.

Fig. 10.35 Solid-pseudopapillary neoplasm. The pseudopapillary structures are lined by small monomorphic cells.

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