Original Paper

Metastasis to the Pancreas: Characterization by Morphology and Contrast Enhancement Features on CT and MRI
Moritz Palmowski^{a, b}, Nicola Hacke^b, Stefanie Satzl^b, Miriam Klauss^b, Moritz N. Wente^c, Martin Neukamm^b, Joerg Kleeff^c, Peter Hallscheidt<sup>b

a</sup>Division of Medical Physics in Radiology, German Cancer Research Center, and Departments of
^bDiagnostic Radiology and
^cGeneral Surgery, University of Heidelberg, Heidelberg, Germany

Address of Corresponding Author

Pancreatology 2008;8:199-203 (DOI: 10.1159/000128556)

  Key Words

• Metastasis
• Pancreas
• Renal cell carcinoma
• Magnetic resonance imaging
• Computed tomography

  Abstract

Aims: To investigate the characteristics of metastasis to the pancreas using computed tomography (CT) and magnetic resonance imaging (MRI). Methods: Twenty-two patients with metastases to the pancreas were examined preoperatively by MRI (7/22) and/or multidetector CT (15/22). Pre- and post-contrast images were acquired and morphology, size, and contrast enhancement of the tumor analyzed. Subsequently, all patients underwent surgery, and the histopathologic findings were compared with the imaging results. Results: In 22 patients, a total of 29 metastases were found on CT and MRI. These metastases originated from renal cell carcinomas (RCC; 22/29), colorectal carcinoma (3/29), and other malignancies (4/29). The metastases differed not in size or location, but in their contrast enhancement characteristics. RCC metastases had either intense homogeneous enhancement (in small lesions) or rim enhancement (in large lesions). Outer regions of colorectal metastases showed no difference from normal pancreatic tissue, whereas the inner area showed hypo-enhancement due to central necrosis. Conclusion: Imaging features of metastases from RCC point to their primary origin. While they can be distinguished from primary adenocarcinoma of the pancreas, differentiation from endocrine carcinoma might be difficult. Differentiation of colorectal carcinoma remains to be investigated on larger numbers of cases.

Copyright © 2008 S. Karger AG, Basel and IAP

  Author Contacts

Prof. Dr. Peter Hallscheidt
Department of Diagnostic Radiology, University of Heidelberg, INF 110
DE-69120 Heidelberg (Germany)
Tel. +49 6221 563 6418, Fax +49 6221 565 730
E-Mail peter.hallscheidt@med.uni-heidelberg.de

  Article Information

Received: July 30, 2007
Accepted after revision: November 27, 2007
Published online: April 23, 2008
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 1, Number of References : 18