Pancreatic neuroendocrine tumor and serous cystadenoma

Case contributed by Dr Ammar Haouimi

Presentation

Chronic epigastric pain. Upper GI endoscopy was normal. Laboratory investigations were normal including blood glucose level.

Patient Data

Age: 35 years
Gender: Female

The MRI sequences demonstrate:

  • fusiform band in the segment 4 of the liver of high signal on T1 GE in-phase attenuated on out-phase sequence as well as T2 fat sat with no enhancement on postcontrast sequences in keeping with focal hepatic steatosis (echogenic on ultrasound not shown)
  • relatively well-circumscribed lobulated soft tissue mass of the corporeal segment of the pancreas measuring (3.8 x 2.9 x 2.6 cm) of low signal on T1, high signal on T2 with restricted diffusion. The postcontrast sequences show an intense and homogeneous enhancement in the arterial phase, and isointense to the normal pancreatic parenchyma in the portal phase
  • well-defined cystic lesion of the pancreatic tail (2.9 x 2.2 x 2 cm) of low signal on T1, high signal on T2 with no restricted diffusion. The postcontrast sequences show the peripheral rim of enhancement

Conclusion of the pathological report:

  • well-differentiated neuroendocrine tumor of the solid corporeal pancreatic mass
  • serous cystadenoma of the caudal pancreatic cystic mass

Case Discussion

MRI features of double pancreatic lesion, corporeal of solid nature with restricted diffusion suggestive of neuroendocrine tumor, and caudal of cystic nature with no restricted diffusion suggestive of serous cystadenoma (pathologically proven).

Focal hepatic steatosis in segment 4 (incidental finding) which is considered as a characteristic location. 

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