“Pancreatic ductal adenocarcinoma. Typical findings, unusual presentation and its mimics.”

Congress:

ECR 2020

Poster Number:

C-05749

Type:

Educational Exhibit

Keywords:

Not applicable, Education and training, Cancer, Endoscopy, Biopsy, MR-Cholangiography, CT, Pancreas, Oncology, Abdomen, Abdominal Viscera

Authors:

M. L. Payva¹, C. Bogado Del Popolo¹, R. Orta², P. Baigorria¹, A. Pelaez¹, R. L. Villavicencio¹; ¹rosario/AR, ²Buenos Aires/AR

DOI:

10.26044/ecr2020/C-05749

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-05749

Fig. 1: Pancreatic adenocarcinoma typical presentation. Axial CT scan and curve MPR...

Fig. 3: Adenocarcinoma and acute pancreatitis. Axial T2 WI (a and b) show inflammatory...

Fig. 4: Adenocarcinoma with cystic changes. Axial T2 WI (a) and postcontrast T1FS WI...

Fig. 5: Adenocarcinoma with extensive retroperitoneal involvement. Axial CT scan portal...

Learning objectives

1- To outline pancreatic ductal adenocarcinoma typical imaging findings. 2- To learn about atypical imaging presentations. 3- To give an insight into main differential diagnoses of benign and malignant conditions

Background

Pancreatic adenocarcinoma is the most common malignancy of the pancreas with a high mortality, accounting for over 90% of all pancreatictumors. [1] Early pancreatic cancers often do not cause any signs or symptoms. By the time they do cause symptoms, they have often grown large or already spread outside the pancreas. CT and MRI scans have become the most important modalities for evaluating pancreatic lesions. However, precise diagnosis of pancreatic adenocarcinoma is not always straightforward because they frequently show atypical imaging features and many other...

Findings and procedure details

Pancreatic ductal adenocarcinoma: Typical presentation: The typical CT and MRI features of pancreatic adenocarcinoma are an infiltrative pancreatic mass with ill-defined margins, often with resultant obstruction of the pancreatic duct. It is most commonly located in the pancreatic head where an indirect sign which is called the “double duct sign” could be present, indicating pancreatic and common bile duct obstruction. [2] It often causes distortion of the gland contour, atrophy and local vascular involvement. Metastases occur into regional nodes, liver and the peritoneal cavity (80%...

Conclusion

Neoplastic and non-neoplastic diseases can closely simulate pancreatic adenocarcinoma. Familiarity of common and uncommon CT and MRI manifestations of pancreatic adenocarcinoma and its main differentials is essential to achieve the correct diagnosis.

Personal information and conflict of interest

M. L. Payva; Rosario/AR - nothing to disclose C. Bogado Del Popolo; Rosario/AR - nothing to disclose R. Orta; Buenos Aires/AR - nothing to disclose P. Baigorria; Rosario/AR - nothing to disclose A. Pelaez; Rosario/AR - nothing to disclose R. L. Villavicencio; Rosario/AR - nothing to disclose

References

1- Galvin Low, MBChB, MRCS, FRCR, Anukul Panu, MD, Noam Millo, MD, Edward Leen, MD, FRCR. Multimodality Imaging of Neoplastic and Non-neoplastic Solid Lesions of the Pancreas. Radiographics 2011; 31:993-1015. 2- Min-Jie Yang, Su Li, Yong-GuangLiu,NaJiao, Jing-Shan Gong. Common and Unusual CT and MRI Manisfestations of Pancreatic Adenocarcinoma: A Pictorial Review. Quant Imaging Med surg 2013; 3(2): 113-120. 3-E. Frampas, O Morlaa, N Regenet, T. Eugènec, B. Dupas, G Meurette. A solid Pancreatic Mass: Tumour or Inflammation?. Diagnostic and Interventional Imaging. (2013) 94, 741-755. 4-Shaojun...