Magnetic resonance imaging of pancreatic metastases from renal cell carcinoma

Sikka, Amrita; Adam, Sharon Z.; Wood, Cecil G.; Hoff, Frederick L.; Harmath, Carla; Miller, Frank H.

doi:10.1016/j.clinimag.2015.07.012

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…It is well known that PDAC most commonly involves the pancreatic head, as also shown in our series. Conversely, our results showed PM had no predilection for a particular segment of the pancreas, in line with previous studies [23]. On unenhanced CT most PM were hypo-or isoattenuating to normal pancreatic parenchyma, with no significant differences with PDAC.…”

Section: Discussionsupporting

confidence: 92%

“…The differential diagnoses of hypervascular PM are primary pancreatic neuroendocrine tumor, intrapancreatic accessory spleen, and vascular lesions such as arteriovenous fistulas or aneurysms of the splenic artery [27,29,30]. Isolated PM from renal cell carcinoma may occur after a long disease free interval [23,31], especially from the clear cell type of primary tumor, and should be differentiated from primary pancreatic endocrine tumor, which may be an incidental finding on cross sectional imaging. Indeed, large non-functional pancreatic neuroendocrine tumors may be asymptomatic for a long time, while small functional neuroendocrine tumors may develop symptoms secondary to hormone secretion [32].…”

Section: Discussionmentioning

confidence: 99%

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Imaging features of pancreatic metastases: A comparison with pancreatic ductal adenocarcinoma

et al. 2018

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Imaging features of pancreatic metastases: A comparison with pancreatic ductal adenocarcinoma

et al. 2018

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“…Isolated metastases can develop, usually in the pancreatic head, and mimic primary pancreatic neoplasms. Secondary involvement can occasionally manifest as multicentric lesions or diffuse infiltration (94,95).…”

Section: Secondary Tumors: Malignant Metastasesmentioning

confidence: 99%

“…Of note, the majority of pancreatic metastases have discrete well-defined margins with smooth borders (Fig 19c, 19d) (94). Although the lesions can be detected at nonenhanced CT and MR imaging, these modalities are not helpful in distinguishing primary and secondary tumors because of significant overlap (most are hypoattenuating to pancreas at CT and T1 hypointense and T2 hyperintense at MR imaging) (94,95).…”

Section: Secondary Tumors: Malignant Metastasesmentioning

confidence: 99%

Nonepithelial Neoplasms of the Pancreas, Part 2: Malignant Tumors and Tumors of Uncertain Malignant PotentialFrom the Radiologic Pathology Archives

Manning

Paal²,

Srivastava

et al. 2018

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Almost all neoplasms of the pancreas are derived from pancreatic epithelial components, including the most common pancreatic mass, primary pancreatic ductal adenocarcinoma (PDAC). Nonepithelial neoplasms comprise only 1%-2% of all pancreatic neoplasms. Although some may arise directly from intrapancreatic elements, many originate from mesenchymal, hematopoietic, or neural elements in the retroperitoneal peripancreatic space and grow into the pancreas. Once these tumors reach a certain size, it can be challenging to identify their origin. Because these manifest at imaging as intrapancreatic masses, awareness of the existence and characteristic features of these nonepithelial neoplasms is crucial for the practicing radiologist in differentiating these tumors from primary epithelial pancreatic tumors, an important distinction given the vastly different management and prognosis. In part 1 of this article, the authors reviewed benign nonepithelial neoplasms of the pancreas. This article focuses on malignant nonepithelial neoplasms and those of uncertain malignant potential that can be seen in the pancreas. The most common malignant or potentially malignant nonepithelial pancreatic tumors are of mesenchymal origin and include soft-tissue sarcomas, solitary fibrous tumor, and inflammatory myofibroblastic tumor. These tumors commonly manifest as large heterogeneous masses, often containing areas of necrosis and hemorrhage. The clinical features associated with these tumors and the imaging characteristics including enhancement patterns and the presence of fat or calcification help distinguish these tumors from PDAC. Hematopoietic tumors, including lymphoma and extramedullary plasmacytoma, can manifest as isolated pancreatic involvement or secondarily involve the pancreas as widespread disease. Hyperenhancing paragangliomas or hypervascular metastatic disease can mimic primary pancreatic neuroendocrine tumors or vascular anomalies.

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“…At contrast-enhanced CT, pancreatic metastatic lesions are most often hypervascular and demonstrate avid early arterial phase enhancement followed by rapid washout in subsequent phases (45,66) (Fig 5). While metastases most often remain hyperattenuating in the portal venous phase relative to the background parenchyma, hypointense relative to the parenchyma, and at diffusion-weighted MRI, pancreatic metastases are more often hyperintense (67,68).…”

Section: Late Manifestationsmentioning

confidence: 99%

Current Challenges in Diagnosis and Assessment of the Response of Locally Advanced and Metastatic Renal Cell Carcinoma

et al. 2019

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Locally advanced and metastatic renal cell carcinoma (RCC) present a specific set of challenges to the radiologist. The detection of metastatic disease is confounded by the ability of RCC to metastasize to virtually any part of the human body long after surgical resection of the primary tumor. This includes sites not commonly included in routine surveillance, which come to light after the patient becomes symptomatic. In the assessment of treatment response, the phenomenon of tumor heterogeneity, where clone selection through systemic therapy drives the growth of potentially more aggressive phenotypes, can result in oligoprogression despite overall disease control. Finally, advances in therapy have resulted in the development of immuno-oncologic agents that may result in changes that are not adequately evaluated with conventional sizebased response criteria and may even be misinterpreted as progression. This article reviews the common challenges a radiologist may encounter in the evaluation of patients with locally advanced and metastatic RCC.

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Magnetic resonance imaging of pancreatic metastases from renal cell carcinoma

Cited by 10 publications

References 19 publications

Imaging features of pancreatic metastases: A comparison with pancreatic ductal adenocarcinoma

Imaging features of pancreatic metastases: A comparison with pancreatic ductal adenocarcinoma

Nonepithelial Neoplasms of the Pancreas, Part 2: Malignant Tumors and Tumors of Uncertain Malignant PotentialFrom the Radiologic Pathology Archives

Current Challenges in Diagnosis and Assessment of the Response of Locally Advanced and Metastatic Renal Cell Carcinoma

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