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Contrast-enhanced multiphasic CT and MRI findings of adenosquamous carcinoma of the pancreas

  • Yuqin Ding
    Affiliations
    Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging, Institute, Shanghai 200032, People's Republic of China

    Department of Medical Imaging, Shanghai Medical School of Fudan University, Shanghai, 200032, People's Republic of China
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  • Jianjun Zhou
    Correspondence
    Corresponding author. Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai, Medical Imaging Institute, 180 Fenglin Road, Shanghai, 200032, People's Republic of China. Tel.: +86 13661497109; fax: +86 021 64439906.
    Affiliations
    Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging, Institute, Shanghai 200032, People's Republic of China

    Department of Medical Imaging, Shanghai Medical School of Fudan University, Shanghai, 200032, People's Republic of China
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  • Huihong Sun
    Affiliations
    Department of radiology, The first affiliated hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
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  • Deming He
    Affiliations
    Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, People's Republic of China
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  • Mengsu Zeng
    Affiliations
    Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging, Institute, Shanghai 200032, People's Republic of China

    Department of Medical Imaging, Shanghai Medical School of Fudan University, Shanghai, 200032, People's Republic of China
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  • Shengxiang Rao
    Affiliations
    Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging, Institute, Shanghai 200032, People's Republic of China

    Department of Medical Imaging, Shanghai Medical School of Fudan University, Shanghai, 200032, People's Republic of China
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Published:September 12, 2013DOI:https://doi.org/10.1016/j.clinimag.2013.08.002

      Abstract

      Objective

      The objective was to retrospectively study computed tomography (CT) and magnetic resonance imaging (MRI) findings of adenosquamous carcinoma of the pancreas (PASC).

      Materials and Methods

      Twelve patients (six women and six men; mean age, 61.3 years; range, 47–78 years) who presented with PASC as documented by pathologic examination underwent CT (n=10) or both CT and MRI (n=2) examination. Two radiologists evaluated the images and determined the location, size, margin, internal attenuation or signal intensity, contrast enhancement, and pattern for each tumor. Additionally, the presence of poorly enhanced areas, upstream main pancreatic duct (MPD) dilatation, pancreatic atrophy, and peripancreatic tissue metastasis were evaluated. Images were cross-referenced to surgical and pathologic findings.

      Results

      Masses were distributed throughout the pancreas (head, n=6; body, n=1; and tail, n=5). The tumor size ranged from 2.4 to 5.5 cm with an average size of 3.7 cm. Eight (66.7%) masses were ill defined, and seven (58.3%) were partially exophytic. Twelve (100%) masses showed heterogeneous and poorly enhanced areas. The lesions showed weak (n=5), moderate (n=5), or intense (n=2) progressive enhancement. The diameter of MPD in six patients ranged from 3.0 to 5.0 mm with an average of 3.7 mm. Pancreatic atrophy was not found. In 10 patients (83.3%), masses invaded the peripancreatic tissues. Two patients had metastatic liver disease at presentation.

      Conclusion

      PASC typically presented as an ill-defined, hypovascular mass with a poorly enhanced area, exophytic tendency, and peripancreatic tissue invasion. Lack of pancreatic atrophy and mild MPD dilatation were also distinct from common duct pancreatic adenocarcinoma.

      Keywords

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