Small undifferentiated pancreatic adenocarcinoma which mimics IPMN at imaging

Mirko D'Onofrio, Francesca Vecchiato, Anna Galotti, Massimo Falconi, Paola Capelli, Roberto Pozzi Mucelli

Research output: Contribution to journalArticlepeer-review

Abstract

Context: To present the case of an unusual presentation at imaging of a very small solid undifferentiated pancreatic adenocarcinoma which mimics a side-branch intraductal papillary mucinous neoplasm. Case report: The patient came to our hospital for a revaluation of a cystic pancreatic lesion. Ultrasound (US) and contrast-enhanced ultrasound (CEUS) examinations were carried out. A small cystic lesion of about 1.5 cm in diameter was seen in the posterior aspect of the pancreatic uncinate process A very small, solid, vascularized nodule was detected at CEUS within the lesion. Consequently, the patient underwent CT and MRI. MRI confirmed the presence of an intralesional nodule and communication with the main pancreatic duct was demonstrated, suggesting the diagnosis of intraductal papillary mucinous neoplasm with solid intralesional tissue. A pylorus preserving pancreaticoduodenectomy was carried out. An undifferentiated adenocarcinoma having a notable peripheral inflammatory reaction and dilated branch duct was finally diagnosed. Conclusion: To our knowledge, we present for the first time, the case of a very small solid undifferentiated pancreatic adenocarcinoma of the uncinate process which mimicked a side-branch intraductal papillary mucinous neoplasm at imaging. The cystic appearance may be an epiphenomenon of a solid lesion and this possibility has to be considered when one encounters incidental cystic lesions at imaging.

Original languageEnglish
Pages (from-to)406-408
Number of pages3
JournalJournal of the Pancreas
Volume10
Issue number4
Publication statusPublished - 2009

Keywords

  • Magnetic resonance imaging
  • Pancreas
  • Pancreatic neoplasms
  • Pancreaticoduodenectomy

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Hepatology

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