תשובה ל- Case 5

מרצה: Tal Arazi-Kleinman M
Diagnostic Imaging Department, Shiba Medical Center, Sackler Medical School, Tel Aviv University
C. Pancreatic neuroendocrine tumour (Islet cell tumour)
  • The main differential diagnosis of a large solid mass at the tail of the pancreas isodense to normal pancreatic parenchyma with calcifications that enhances post contrast injection is non functional neuroendocrine tumor. Most pancreatic adenocarcinomas are hypoenhancing with respect to the surrounding normal parenchyma on dynamic contrast enhanced CT. Functional neuroendocrine tumors demonstrate very small hypervascular lesions on dynamic contrast enhanced CT.

Figure 1a
Legends
Figure 1(a-c): (a) Pre-contrast enhancement axial CT image of the upper abdomen shows an ill-defined mass with a small calcification at the tail of the pancreas (arrow), isodense to normal pancreatic parenchyma.

Figure 1b
(b) Dynamic CT enhancement axial image in the arterial phase at the same level shows enhancement of the mass (arrow).

Figure 1c
(c) A contrast enhanced axial CT image in the porto-venous phase at a higher level than figures 1a and 1b shows multiple hypodense lesions in both lobes of the liver representing hemorrhage in the metastatic liver lesions (arrow).