Presentation
Hyperinsulinism.
Patient Data
CT-scans shows a subtle hypervascular pancreatic lesion located at the junction of the body and tail of the pancreas, compatible with a neuroendocrine pancreatic tumor (pancreatic islet cell tumor).
Moreover, there are multiple liver lesions and pelvic carcinomatous nodules, indistinguishable from the ovaries.
Octreoscan (somatostatin receptor scintigraphy) done one month later shows excessive somatostatin receptor expression in the liver and pancreas, compatible with a metastatic neuroendocrine tumor of pancreatic origin. There was a significant progression in this one month period follow-up.
MRI done two months later shows an important progression of liver metastases. The pancreatic lesions has grown and it shows heterogeneous enhancement following gadolinium administration. Pelvic carcinomatosis is not seen on this MRI.
Case Discussion
There aren't many hypervascular pancreatic lesions except endocrine tumors of the pancreas. Apart from purely vascular lesions (aneurysm / pseudo-aneurysm), which should be easily identified on C+ studies, hypervascular metastases are amongst the only true differential diagnosis.
Related article:
Unable to process the form. Check for errors and try again.