Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma

• 作者: Antongiulio Faggiano Gelsomina Mansueto Luigi Camera Marco Salvatore Rosa Fonti Rosa Severino Simone Maurea Stefania Masone
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: PANCREATIC endocrine tumor Vasoactive intestinal peptide Multi-detector computed tomography CONTRAST induced nephropathy Magnetic resonance imaging Nephrogenic systemic fibrosis SOMATOSTATIN receptor SCINTIGRAPHY
• 年，卷（期）: 2014,（10）
• 页码范围: 840-845
• 页数: 6页
• 分类号: R735.9

摘要

Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography(CT) or magnetic resonance(MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved bysomatostatin-receptor scintigraphy(SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR(Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT(Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure(3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.