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Osteomyelitis
Joseph Junewick, MD FACR
over 7 years ago
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Metastatic Pancreatic Adenocarcinoma

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: MR CT NM
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History

Teenager with abnormal hepatic function tests.


Case Images


Diagnosis

Metastatic Pancreatic Adenocarcinoma

Findings

CT – Hypodense mass in pancreatic neck with multiple hepatic lesions.

MR – Axial T2 images confirm CT findings.

PET – Hypermetabolic pancreatic and hepatic lesions.

Discussion

Ductal adenocarcinoma with its variants is the most common neoplasm of the pancreas, however, the tumor is rare under the age of 40 years and ever more rare in children. Genetic predisposition (hereditary pancreatitis, hereditary pancreatic cancer syndrome, hereditary non-polyposis colon carcinoma, Peutz-Jeghers syndrome, familial atypical multiple mole melanoma, and BRCA2) can usually be traced to pediatric cases of pancreatic adenocarcinoma. Children are more apt to present with metastatic disease but otherwise there is little significant difference with adult onset of the disease. At imaging, pancreatic ductal adenocarcinomas are small, echogenic and inhomogeneous at US, hypoattenuating at CT, and T1 hypointense/T2 variable/hypoenhancing on MR.

Reference

Chung EM, Travis MD, Conran RM. Pancreatic Tumors in Children: Radiologic-Pathologic Correlation. Radiographics (2006); 26: 1211-1238.



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