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ECR 2019 / C-2486
Pancreatic Pseudotumors: Lesions that can mimic primary pancreatic neoplasms.
Congress: ECR 2019
Poster No.: C-2486
Type: Educational Exhibit
Keywords: Education and training, Education, MR, CT, Pancreas, Gastrointestinal tract, Abdomen
Authors: D. Strabelli, L. Coura, G. A. B. G. Bandeira, M. H. Verussa, I. S. Oliveira, M. D. S. Rocha; São Paulo/BR
DOI:10.26044/ecr2019/C-2486

Background

 

  • The pancreas is a retroperitoneal organ with complex anatomical relationships with peritoneal and retroperitoneal structures (Figure 1 and 2). Lesions originating from these locations might be intrinsically related to the pancreatic parenchyma, simulating pancreatic primary neoplasms.

  • Studies show that up to 5% of the pancreatectomies performed due to a primary clinical diagnosis of pancreas cancer are later proved to be pseudotumors by microscopic evaluation [3].

  • Pancreas primary neoplasms can be solid or cystic. Adenocarcinoma represents the majority of all primary pancreatic neoplasms, typically presenting with non-specific symptoms and as a hypovascular solid mass on imaging [4]. These findings may overlap with pancreatic and peripancreatic non-neoplastic conditions and the accurate diagnosis is essential, given the poor prognosis of this tumor. Also, it is important to recognize the imaging pattern of neuroendocrine tumors, the second most prevalent solid neoplasm, with different features and prognosis.

 

 

Fig. 1: A: Schematic pancreas anatomy division. B, C, D: Portal venous phase CT images in coronal and axial views, representing the same schematic pancreas anatomy.
References: Radiologia, FMUSP -SP, Hospital das clínicas da Faculdade Estadual de Medicina de Sao Paulo - São Paulo/BR
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