Rare pancreatic tumors.
Anup S. Shetty, MD'Correspondence information about the author MD Anup S. ShettyEmail the author MD Anup S. Shetty, Christine O. Menias, MD DOI: https://doi.org/10.1016/j.mric.2018.03.007
Pancreatic ductal adenocarcinoma (PDAC) (90%) and neuroendocrine tumors (5%) comprise most malignant pancreatic neoplasms.1 A variety of cystic neoplasms of the pancreas, ranging from intraductal papillary mucinous neoplasms to serous and mucinous cystadenomas to solid pseudopapillary neoplasms, are also well known to most radiologists. However, a variety of rare benign and malignant pancreatic tumors may be encountered that radiologists are unfamiliar with. An important consideration in evaluating solid pancreatic lesions is an appearance atypical of PDAC, such as the lack of pancreatic ductal dilation or distal atrophy, that might lead the radiologist to consider a rare tumor. Pancreatic neoplasms may be of exocrine, endocrine, mesenchymal, or extrapancreatic origin; imaging features of the rare pancreatic tumors are often nonspecific. Knowledge of the patients’ history for clues to guide the radiologist is key, such as a history of neurofibromatosis type I or a primary renal cell carcinoma (RCC) or melanoma; but in many cases tissue sampling will be required to confirm the diagnosis. An MR imaging protocol for comprehensive evaluation of the pancreas is described in Table 1. This article reviews a variety of rare pancreatic tumors (Table 2) with magnetic resonance (MR) and computed tomography (CT) case examples.