Solid Pseudopapillary Neoplasm of the Pancreas: Typical, Atypical, and Mimicking Lesions—A Pictorial Review

Abstract

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors that predominantly affect young women and are characterized by encapsulated lesions with a mixture of solid and cystic components. Although typically indolent with a favorable prognosis after surgical resection, SPNs can exhibit atypical features that complicate diagnosis, including dense calcifications, multiplicity, or occurrence in male and elderly patients. Magnetic resonance imaging plays a pivotal role in distinguishing SPNs from other pancreatic lesions, leveraging its superior contrast resolution to identify hallmark findings such as hemorrhage, cystic degeneration, and enhancement patterns. This review highlights both typical and atypical imaging presentations of SPNs and discusses key differential diagnoses, including pancreatic adenocarcinoma, neuroendocrine tumors, and mucinous cystic neoplasms. By broadening awareness of the variable manifestations of SPNs and integrating imaging with clinical and epidemiological data, this study aims to improve diagnostic accuracy and guide effective management strategies for ambiguous pancreatic lesions.