Learning objectives
To describe the characteristics of pancreatic ductal adenocarcinomaUS,
CT and MRI imaging and to provide solid basis for differential diagnosis
To describe pitfalls and differential diagnosis of hypovascular pancreatic mass,
including congenital,
benign,
and malignant conditions
Background
Pancreatic ductal adenocarcinoma (PDAC) represents the fourth leading cause of cancer-related mortality,
associated with an extremely poor outcome and 5% of five-year survival rate due to its aggressiveness.
Early diagnosis is crucial for patient's clinical history,
leading to surgical treatment in case of resectable PDAC or neoadjuvant chemotherapy in the case of locally advanced cancer.
If early surgical and chemotherapy treatment can determine survival improvement,
on the other hand,
misdiagnosis of benign or non-neoplastic entities that mimic PDAC may lead to diagnostic error and use...
Findings and procedure details
The diagnosis of hypovascular masses remains challenging due to overlapping in imaging appearance with other rarer encountered entities mimicking PDAC.
In treatment planning for PDAC it is necessary to obtain a histological characterization of the mass to start neoadjuvant chemotherapy treatment,
but not to perform pancreatectomy if the clinical suspicion of pancreatic neoplasm is strong,
even in case of a negative biopsy.
This management increases the sensitivity of the diagnosis but reduces its specificity,
as it can be seen from study data that showed that...
Conclusion
The differential diagnosis among these entities is crucial in order to proceed with the right therapeutical approach and to avoid unnecessary surgical and diagnostic procedures.
Personal information
Dr Giulia Carpani,
Radiology resident,
Sant'Orsola-Malpighi Hospital,
University of Bologna,
Italy
[email protected]
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