Neuroendocrine tumors of the pancreas: Spectrum of appearances on MRI

Semelka, Richard C.; Custodio, Carolina M.; Balci, N. Cem; Woosley, John T.

doi:10.1002/(sici)1522-2586(200002)11:2<141::aid-jmri10>3.0.co;2-u

Cited by 184 publications

(85 citation statements)

References 13 publications

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“…In the study by Owen et al [34] , 14 out of 29 (48.3%) lesions demonstrated this finding, while only one out of 29 (3.4%) showed a reversal of signal, that is, T1 hyperintensity and T2 hypointensity. The study by Semelka et al [35] showed a positive predictive value of 96% for MRI in pancreatic NETs. Gastrinomas tend to show ring or peripheral enhancement while most other subtypes of NETs demonstrated a diffuse pattern of enhancement.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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Imaging of gastroenteropancreatic neuroendocrine tumors can be broadly divided into anatomic and functional techniques. Anatomic imaging determines the local extent of the primary lesion, providing crucial information required for surgical planning. Functional imaging, not only determines the extent of metastatic disease spread, but also provides important information with regard to the biologic behavior of the tumor, allowing clinicians to decide on the most appropriate forms of treatment. We review the current literature on this subject, with emphasis on the strengths of each imaging modality.

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Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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“…During the mid 1990s, two-phase dynamic incremental CT was considered standard, with a reported sensitivity ranging from 64-82% [10,11]. The role of MRI, however, has quickly gained recognition as an equivalent, if not superior, modality for diagnosing pancreatic tumors, with a reported sensitivity of 75-100% [11,12]. There is also a suggestion that MRI may be superior in imaging tumors less than 2.5 cm in diameter [12] with one retrospective study finding tumors as small as 1 cm in diameter [12].…”

Section: Diagnosismentioning

confidence: 99%

Vasoactive Intestinal Peptide Tumor

Natanzi

Amini

Yamini

et al. 2009

Scholarly Research Exchange

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Background and aim. Vasoactive intestinal peptide tumor is a rare neuroendocrine neoplasm which causes voluminous watery diarrhea via hypersecretion of electrolytes and water from the intestinal mucosa through a vasoactive intestinal peptide-mediated, cyclic AMP-dependent mechanism. The acid base imbalance generated by the loss of water and electrolytes leads to severe dehydration and potential renal failure, which can ultimately result in death if left untreated. This paper aims to review the clinical, histological, radiological, and diagnostic features of this disease as well as the therapeutic modalities in treating this condition. Methods. A review of literature was performed using MEDLINE, Pubmed, and Cochrane databases in collection of data using MeSH terms including vasoactive intestinal peptide, VIPoma, and WDHA. Results and conclusion. Vasoactive intestinal peptide tumor is a rare neoplasm associated with significant morbidity and mortality through secretion of water and electrolytes in the gastrointestinal tract. The nonspecific clinical presentation of this neoplasm can pose diagnostic challenges, as these tumors can be easily misdiagnosed as other conditions, ranging from laxative overdose to the presence of a carcinoid secreting tumor. Nevertheless, a number of imaging and laboratory studies can facilitate the correct evaluation and diagnosis of VIPoma. Following proper diagnosis, VIPomas are treated by either medical or surgical modalities depending on the existence and extent of metastasis.

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“…The syndrome, also named WDHA (Watery Diarrhoea, Hypokalaemia, Achlorhydria), is caused by the excessive production of the Vasoactive Intestinal Peptide (VIP) which stimulates fluid and electrolyte secretion in the intestinal epithelium through the activation of cyclic adenosine mono-phosphate pathway [3] . As most endocrine pancreatic tumors appear as hypervascular nodular lesions at either contrast-enhanced computed tomography (CT) or magnetic resonance (MR), cross-sectional imaging findings of pancreatic vipomas are usually not specific [4][5][6][7] . However, the role of both CT and/or MR is pivotal to localize the lesion and evaluate its size and anatomic relationships in view of a surgical approach which represents the standard of care [8] .…”

Section: Introductionmentioning

confidence: 95%

“…Unenhanced MR showed a definite oval mass, hypointense in T1-FFE sequences (Figure 2A) and mildly hyper-intense in the HASTE-T2-weighted sequences ( Figure 2B), at the level of the pancreatic tail (Figure 2). Although these signal intensities are commonly observed in pancreatic endocrine tumors, they are not specific [6,7] . Some endocrine tumors may indeed characteristically exhibit a low signal intensity on T2-weighted sequence as a result of their collagen content [4] , but this was not the Immunohisto-chemical analysis showed intense and uniform staining with Chromogranin-A ( Figure 4A) with less than 2% of cells positive with Ki-67 ( Figure 4B) as usually observed in well-differentiated neuro-endocrine tumors, currently classified as well-differentiated vipoma (NET G1) [19] .…”

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confidence: 99%

Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma

Camera

Severino

Faggiano

et al. 2014

WJR

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Core tip: Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography (CT) or magnetic resonance (MR) is pivotal for surgical planning. We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR. The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT but it was subsequently confirmed by somatostatin-receptor scintig- CASE REPORT

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Neuroendocrine tumors of the pancreas: Spectrum of appearances on MRI

Cited by 184 publications

References 13 publications

Imaging of gastroenteropancreatic neuroendocrine tumors

Imaging of gastroenteropancreatic neuroendocrine tumors

Vasoactive Intestinal Peptide Tumor

Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma

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