Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma
Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma作者机构：Department of Advanced Biomedical Sciences Diagnostic Imaging Section University "Federico Ⅱ"80131 Naples Italy Institute of Biostructures and Bioimaging (C.N.R.)80131 Naples Italy Department of Clinical Medicine and Surgery Endocrinology Section University "Federico Ⅱ"80131 Naples Italy Department of Gastro-enterology Endocrinology and Surgery University "Federico Ⅱ"80131 Naples Italy Department of Advanced Biomedical Sciences Pathology Section University "Federico Ⅱ"80131 Naples Italy
出 版 物：《World Journal of Radiology》 (世界放射学杂志（英文版）（电子版）)
年 卷 期：2014年第6卷第10期
页 面：840-845页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Pancreatic endocrine tumor Vasoactive intestinal peptide Multi-detector computed tomography Contrast induced nephropathy Magnetic resonance imaging Nephrogenic systemic fibrosis Somatostatin receptor scintigraphy
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.
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