Baba Hiroshi, Yamada Yasunari, Tada Kazuhiro, Kuboyama Yusuke, Fukuzawa Kengo, Iwaki Kentaro, Motomura Mitsuteru, Takaji Ryo, Shimada Ryuichi, Takaki Hajime, Asayama Yoshiki
Department of Radiology, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan.
Department of Surgery, Oita Red Cross Hospital, Chiyo-machi, Oita , Japan.
Radiol Case Rep. 2023 Oct 9;18(12):4422-4430. doi: 10.1016/j.radcr.2023.09.032. eCollection 2023 Dec.
Pancreatic mixed acinar-neuroendocrine carcinomas are rare malignant tumors of the pancreas. They are composed histologically of both acinar and neuroendocrine cells. The pancreatic duct is known to be an important site of tumor growth for acinar cell carcinomas, neuroendocrine tumors, and intraductal tubulopapillary neoplasms. To the best of our knowledge, there has been only 1 report of a mixed acinar-neuroendocrine carcinoma growing into the pancreatic duct and no reports detailing imaging findings with this tumor. We here report a 69-year-old man who presented with worsening glycemic control. Multiphase contrast-enhanced computed tomography and magnetic resonance imaging revealed a well-circumscribed mass with poor contrast enhancement in the pancreatic tail region of the pancreatic duct. The intraductal mass showed diffusion restriction on magnetic resonance imaging. These imaging findings are consistent with the expansive, smooth-surfaced polypoid tumor of low vascularity and high cellularity that was diagnosed pathologically. Mixed acinar-neuroendocrine carcinomas should be included in the differential diagnosis of intraductal tumors of the pancreas with poor contrast enhancement and diffusion restriction.
胰腺混合性腺泡-神经内分泌癌是一种罕见的胰腺恶性肿瘤。它们在组织学上由腺泡细胞和神经内分泌细胞组成。已知胰腺导管是腺泡细胞癌、神经内分泌肿瘤和导管内管状乳头状肿瘤的重要肿瘤生长部位。据我们所知，仅有1例混合性腺泡-神经内分泌癌生长入胰腺导管的报道，且无关于该肿瘤详细影像学表现的报道。我们在此报告1例69岁男性，其血糖控制情况恶化。多期对比增强计算机断层扫描和磁共振成像显示在胰腺导管胰腺尾部区域有一个边界清晰、对比增强不佳的肿块。磁共振成像显示导管内肿块有弥散受限。这些影像学表现与病理诊断的低血管性、高细胞性的膨胀性、表面光滑的息肉样肿瘤一致。胰腺混合性腺泡-神经内分泌癌应纳入胰腺导管内对比增强不佳且有弥散受限的肿瘤的鉴别诊断中。
