Dynamic gadolinium-enhanced MR imaging of pancreatic VIPoma in a patient with Verner-Morrison syndrome

Abstract

We describe a rare case of a pancreatic VIPoma diagnosed in a patient presenting with watery diarrhea, hypokalemia, and achlorhydria, the so-called WDHA or Verner-Morrison syndrome. Emphasis is placed on the dynamic gadolinium-enhanced MR profile of the tumor, characteristics which have not been illustrated previously, to the best of our knowledge.

Ultrasonography of the Pancreas

“…8.21), which can be cytologically confirmed after fine needle aspiration [81]. 8.21), which can be cytologically confirmed after fine needle aspiration [81].…”

“…IPMNs consist of a variety of lesions, highly variable in type and extent, with different biological behavior, pathologically ranging from adenoma to invasive carcinoma passing from borderline lesions with different grades of atypia and noninvasive carcinoma [74][75][76]. However, several papers in the literature describe the imaging features usually observed in malignant tumors [68,[76][77][78][79][80][81][82][83]. Therefore, a clear imaging differentiation between lesions with different pathologic behavior seems impracticable.…”

“…Different pathologic degrees not necessarily reflect different imaging features. In particular, a main duct with a diameter larger than 10 mm is highly suggestive of malignancy [4,68,[76][77][78][79][80][81][82][83]. However, several papers in the literature describe the imaging features usually observed in malignant tumors [68,[76][77][78][79][80][81][82][83].…”

“…CT, MRI, angiography and somatostatin receptor scintigraphy have been used to localize the primary lesion and to identify metastases [80][81][82]. Case reports or series with all types of hyperfunctioning endocrine tumors mixed together have been published.…”