Cystic islet cell tumors: Radiologic findings in three cases

Takeshita, Koji; Furui, Shigeru; Makita, Kohzoh; Yamauchi, Takayoshi; Irie, Toshiyuki; Tsuchiya, Kunihiko; Kusano, Shoichi; Ohtomo, Kuni

doi:10.1007/bf00203512

Cited by 36 publications

(17 citation statements)

References 12 publications

(20 reference statements)

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“…Moreover, some nonendocrine tumors, in particular solid-pseudopapillary tumors or acinar cell carcinomas, present structural patterns similar to those of endocrine tumors making the pathologic diagnosis particularly difficult [8,9,10,11]; however, the distinction between NFET and FET is promptly obtained considering the clinical symptoms of the patient [12]. Even if composed of multiple cell types, FETs have a tendency to develop a single, well-defined, hyperfunctional syndrome, usually more predictive of the type of the tumor than are purely morphologic findings [9,13].…”

Section: Discussionmentioning

confidence: 99%

Nonfunctioning endocrine tumors of the pancreas: possibilities of spiral CT characterization

et al. 2001

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The aim of this study was to assess the ability of spiral CT to adequately characterize the nonfunctioning endocrine tumors (NFETs) of the pancreas, distinguishing this lesion from the other pancreatic tumors. The spiral CT examinations of 21 cases of histologically proven NFETs, along with those of 29 cases of other pancreatic tumors and tumor-like lesions, were retrospectively reviewed in a blinded fashion by two radiologists, in order to correctly classify the lesions, highlighting the typical signs reported in the literature. Discordant cases were further analyzed in the presence of a third radiologist. The final diagnosis was acquired by means of a majority or overall consensus. The histopathologic examination was considered the gold standard. The sensitivity, specificity, and positive and negative predictive values of CT were calculated. After the consensus evaluation, the correct diagnosis was reached in 72% of cases, with 10% of nonspecific diagnoses of solid pancreatic tumor and 18% of wrong diagnoses. The sensitivity and specificity of spiral CT in identifying NFETs were 66.6 and 82.7%, respectively. The positive and negative predictive values were 73.7 and 77.4%, respectively. In up to 70% of cases the NFET demonstrates a typical aspect of a mass hyperdense in the arterial contrastographic phase eventually associated with hyperdense hepatic metastases in more than half of the patients. This finding does allow the diagnosis of NFET but without certainty indeed, since other tumors can show a similar densitometric behavior and among them particularly the ductal adenocarcinoma. On the other hand, both the solid, hypovascularized NFETs, and the cystic form, cannot be differentiated from the other solid and cystic tumors of the pancreas.

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Section: Discussionmentioning

confidence: 99%

Nonfunctioning endocrine tumors of the pancreas: possibilities of spiral CT characterization

et al. 2001

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“…Angiographically, insulinomas exhibit a well-defined, hypervascular, and uniformly dense staining during the capillary phase. Atypical presentations of insulinomas have been described: cystic [15]; calcified [16]; hyperattenuating during unenhanced CT [17]; hypoattenuating on dynamic CT [1]; and hypovascular on angiography [2]. In our case the insulinoma presented an atypical appearance, being hypodense relative to the surrounding parenchyma during the arterial phase images on contrast-enhanced helical CT.…”

Section: Discussionmentioning

confidence: 52%

Unusual presentation of a pancreatic insulinoma in helical CT and dynamic contrast-enhanced MR imaging: case report

et al. 2001

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Insulinomas are pancreatic neoplasms that can be radiologically characterized typically because of their tendency to present intense and early contrast enhancement with a wash-out phenomenon. In this sense, we report an unusual case of a hypovascular solid pancreatic insulinoma confirmed with surgery and pathologic analysis, in a patient with normal serum insulin levels. In the two-phase helical CT, the mass behaved as a hypodense lesion with respect to the surrounding pancreatic parenchyma during the arterial phase and as a hypointense lesion during the dynamic contrast-enhanced MR imaging. Pathologic examination demonstrated a hypercellular tumor with poor vascularization of intervening stroma which showed prominent amyloid deposits.

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“…13 Although it is difficult to make a differential diagnosis of the tumor from SCT based on the image findings alone, it should be noted that the solid part remaining in the nonfunctioning endocrine tumor of the pancreas is hypervascular whereas that of SCT is hypovascular. [14][15][16] These observations, combined with other examinations such as dynamic computed tomography, are therefore expected to facilitate the diagnosis of the tumor.…”

Section: Discussionmentioning

confidence: 97%

Nonfunctioning endocrine tumor of the pancreas with extrapancreatic growth and cyst formation: Report of a case

et al. 2000

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We report a case of nonfunctioning endocrine tumor of the pancreas with extrapancreatic growth and cyst formation. A 48-year-old woman was admitted to our hospital with an upper abdominal mass, which was detected during a routine medical checkup. The preoperative diagnosis was a solid cystic tumor of the pancreas. The tumor, which measured about 7cm in diameter, arose from the head of the pancreas and had a thin stalk, measuring about 1 cm in diameter. The histopathological diagnosis was a malignant nonfunctioning endocrine tumor of the pancreas. Cyst formation occurred in 67% of the reported cases with extrapancreatic growth in Japan. It is speculated that the cyst formation in this disease is related to the large size of the tumor and to the extrapancreatic growth.

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Cystic islet cell tumors: Radiologic findings in three cases

Cited by 36 publications

References 12 publications

Nonfunctioning endocrine tumors of the pancreas: possibilities of spiral CT characterization

Nonfunctioning endocrine tumors of the pancreas: possibilities of spiral CT characterization

Unusual presentation of a pancreatic insulinoma in helical CT and dynamic contrast-enhanced MR imaging: case report

Nonfunctioning endocrine tumor of the pancreas with extrapancreatic growth and cyst formation: Report of a case

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