What are the main differentials to consider?
First, it is necessary to work up the location of the lesion - if duodenal or pancreatic - which is very difficult to be completely sure about. Favouring it as an exophytic uncinate process lesion, a pancreatic neuroendocrine tumour needs consideration. Considering the duodenum (favoured on the report), gastrointestinal stromal tumour (GIST) and, less likely, duodenal carcinoid/neuroendocrine tumour are considerations. Metastatic disease, particularly melanoma, is of consideration.
There is a 3 cm hypervascular lesion involving the D2/D3 duodenal wall. Although closely related to the uncinate process of the pancreas, it appears to have its origin in the duodenum. No necrosis or calcification identified.
Haemoperitoneum related to splenic rupture that was treated with splenic artery embolisation. The spleen is enlarged.
The remainder of the study is unremarkable.