Common cystic pancreatic neoplasms: A comprehensive magnetic resonance imaging-based review of typical and atypical imaging features

Figure 19  Large solid pseudopapillary neoplasm with spontaneous rupture and hemoperitoneum. A and B: Axial and coronal T2-weighted images show a large heterogeneous pancreatic mass with mixed solid and cystic components and extensive intralesional hemorrhage; C and D: Axial and coronal T1-weighted images demonstrate intrinsic high signal intensity consistent with blood products; E and F: Axial post-contrast T1-weighted images show heterogeneous enhancement of the viable solid portions with non-enhancing hemorrhagic areas; G and H: Coronal post-contrast T1-weighted images confirm capsular disruption (arrow) with adjacent fluid collections consistent with hemoperitoneum. In a 16-year-old boy, these findings are consistent with spontaneous rupture of solid pseudopapillary neoplasm complicated by intra-tumoral hemorrhage and hemoperitoneum.