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CASE NUMBER
5,025
Diagnosis
Carcinoma Tail of Pancreas with Dilated Pancreatic Duct
Note
Carcinoma in the tail of the pancreas with dilated pancreatic duct. I think maybe people like this case because you see a cystic component to the lesion and some faint calcification. So you really would look at this case, and the first thing I would think about is, could this be a serous cystadenoma of the pancreas? They often have a Swiss cheese type appearance which is best seen on venous than arterial phase imaging. And they have punctate, central calcifications.
Now one thing that is helpful in this case, perhaps, is the fact there’s a dilated pancreatic duct. It’s rare to get dilitation and distal gland atrophy if it were serous cystadenoma. It occasionally occurs but it is atypical, and so in this case, this was a carcinoma, an adenocarcinoma, simulating a serous cystadenoma.
Just a very nice example to again make us remember that cystic pancreatic tumors do indeed occur but we always think about serous and mucinous and SPEN and IPMN, but you’ve got to be thinking, don’t miss a cystic neuroendocrine tumor, typically with rim enhancement or a cystic adenocarcinoma, which was the case here.
Again, the dilitation and glanular atrophy really help you out on the diagnosis.
Now one thing that is helpful in this case, perhaps, is the fact there’s a dilated pancreatic duct. It’s rare to get dilitation and distal gland atrophy if it were serous cystadenoma. It occasionally occurs but it is atypical, and so in this case, this was a carcinoma, an adenocarcinoma, simulating a serous cystadenoma.
Just a very nice example to again make us remember that cystic pancreatic tumors do indeed occur but we always think about serous and mucinous and SPEN and IPMN, but you’ve got to be thinking, don’t miss a cystic neuroendocrine tumor, typically with rim enhancement or a cystic adenocarcinoma, which was the case here.
Again, the dilitation and glanular atrophy really help you out on the diagnosis.
