Purpose or Case Report: Pancreatic tumours are a rare and unusual entity in pediatric patients accounting for less than 0.2% of malignant paediatric deaths. The limited number of cases and the diversity of histopathologic subtypes have made it difficult to predict prognosis which differs significantly from adults. In general, pancreatic tumours that occur in children are well circumscribed and partially encapsulated. Their relatively soft nature and encapsulated rather than infiltrative growth pattern allow them to become large prior to clinical presentation. Owing to their large size, central necrosis is common.

Causes of pancreatic masses in children are usually benign and include pancreatic pseudocyst, congenital pancreatic cyst, dermoid cyst, hydatid cyst, islet cell tumours, lymphangioma, pancreatic hemangioendothelioma and cystadenomas. Causes of malignant pancreatic masses in children (which are rare) include pancreatoblastoma, lymphoma, neuroblastoma, solid-pseudopapillary tumour and rhabdomyosarcoma.

We present an algorithmic approach to a pancreatic mass in a child, describing the common imaging features in each of the benign and malignant causes of pancreatic mass in a child with radiologic cases. We also report a very rare case of a pancreatic kaposiform hemangioendothelioma in an 8 month old boy who presented with Kasabach Merritt syndrome.

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