What are the most likely metastases to the pancreas?
Metastases in the pancreas are not very common. In most of the cases they come from melanoma (most of the times hyperdense in all phases), lung, breast, ovary and the kidney.
What is the differential diagnosis of an enhanced lesion in a native scan?
A hemorrhagic metastasis or more likely a melanoma metastasis could be of hyperattenuation in a native scan. Therefore only the arterial phase could give you not enough information to differentiate the lesions.
There are at least 5 pancreatic lesions with contrast affinity in the arterial phase in the head, corpus and cauda. Largest is located in the pancreatic head adjacent to the common bile duct. These lesions are isoattenuated to the normal pancreatic parenchyma in the portovenous phase.
A stent is applied in the common bile duct and common hepatic duct. Small air pocket noted in the gallbladder.
Absent right kidney.
Multiple renal cysts of the left kidney, Bosniak I.