Pancreatic solid pseudopapillary neoplasms in male patients exhibit different clinical and imaging features compared with those in female patients

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Abstract
Objectives The purpose of this study was to investigate the clinical and imaging features of solid pseudopapillary neoplasms (SPNs) in men and to compare with those in women. Methods One hundred twenty-two patients (38 men and 84 women) with histologically confirmed SPNs from seven institutions were retrospectively analyzed. Clinical data, including demographics and preoperative diagnoses, were reviewed, and imaging characteristics on computed tomography, magnetic resonance imaging, and 18F-fluorodeoxyglucose positron emission tomography were assessed. Clinical and imaging characteristics were compared between men and women. Results Men were significantly older than women (mean age: 43.7 years vs. 31.1 years, p < 0.001) and had smaller tumors (mean size: 28.5 mm vs. 38.5 mm, p = 0.014). Regarding preoperative diagnosis, SPN was suspected less frequently in men (p < 0.001), with a higher rate of biopsy (p = 0.006). Imaging characteristics revealed that SPNs in men had fewer hemorrhagic changes (p = 0.035), more frequent internal calcifications (p = 0.003), and a higher proportion of solid components (p = 0.009). In women, tumor size (ρ = − 0.292, p = 0.007) and the proportion of solid components (ρ = − 0.276, p = 0.011) negatively correlated with age, whereas no correlations were observed in men. Conclusion SPNs in men exhibit distinct clinical and imaging characteristics, including older age, smaller size, a greater proportion of solid components, and fewer degenerative features compared with those in women. Recognizing these sex-specific differences is important for improving diagnostic accuracy and guiding the optimal management of patients with SPNs. Graphical Abstract

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