Case Of the Week (COW) 26 June 2016
Findings
Widening of C loop of duodenum
DD
Common - Normal variant, Pancreatic mass
Uncommon - Gastrointestinal stromal tumor of duodenum, Hematoma, Leiomyosarcoma, Mesenteric mass, Metastasis, Neoplasm of colon.
Discussion
Majority of malignant pancreatic tumours constitutes adenocarcinomas arising primarily from pancreatic tissue. In systemic metastases of other organ cancers, pancreas is frequently affected, while isolated pancreatic metastasis comprises 2% of all pancreatic cancers . Mostly kidney, breast, lung and colonic cancers and more rarely melanomas and sarcomas metastasize to pancreas. Nearly 6% of all isolated pancreatic cancers metastasize from malignant melanomas Metastasis to pancreas from any organ is generally considered as a worse prognostic factor and the patient is thought to be in his/her terminal phase of the disease. the patient with a mass lesion in the head of the pancreas should be inquired as for malignancies of other organ systems. Ultrasound is the first diagnostic imaging modality to be resorted to in patients with a suspect pancreatic mass who had been previously treated for other organ cancers. Based on ultrasonographic findings, contrasted abdominal CT gives an idea about contrast uptake of the mass lesion, its relationship with adjacent organs and its respectability . CT scan is not always helpful in differentiating primary from secondary pancreatic lesions. Pancreatic metastasis may present as solid or cystic, hypodense or hyper dense lesions.
Findings
Widening of C loop of duodenum
DD
Common - Normal variant, Pancreatic mass
Uncommon - Gastrointestinal stromal tumor of duodenum, Hematoma, Leiomyosarcoma, Mesenteric mass, Metastasis, Neoplasm of colon.
Discussion
Majority of malignant pancreatic tumours constitutes adenocarcinomas arising primarily from pancreatic tissue. In systemic metastases of other organ cancers, pancreas is frequently affected, while isolated pancreatic metastasis comprises 2% of all pancreatic cancers . Mostly kidney, breast, lung and colonic cancers and more rarely melanomas and sarcomas metastasize to pancreas. Nearly 6% of all isolated pancreatic cancers metastasize from malignant melanomas Metastasis to pancreas from any organ is generally considered as a worse prognostic factor and the patient is thought to be in his/her terminal phase of the disease. the patient with a mass lesion in the head of the pancreas should be inquired as for malignancies of other organ systems. Ultrasound is the first diagnostic imaging modality to be resorted to in patients with a suspect pancreatic mass who had been previously treated for other organ cancers. Based on ultrasonographic findings, contrasted abdominal CT gives an idea about contrast uptake of the mass lesion, its relationship with adjacent organs and its respectability . CT scan is not always helpful in differentiating primary from secondary pancreatic lesions. Pancreatic metastasis may present as solid or cystic, hypodense or hyper dense lesions.