[Diagnostic imaging of the remission of a metastasized hormone-producing pancreatic carcinoma (PPom) as affected by polychemotherapy].
The pros and cons of various imaging methods (sonography: plain CT, with contrast medium intravenously/serial CT; x-ray angiography or digital subtraction angiography) in recognising a slow but steady remission of a primary tumour and of liver metastases are discussed, basing on the course of disease in a female patient with a metastasised gastrointestinal malignoma under chemotherapy. Initial chemotherapeutic treatment lasted for two years. Renewed progression after another 2 1/2 years had meanwhile been stopped again by chemotherapy. Sonography and CT control follow-ups were performed on a three-month basis for a total period of more than five years. In sonography, remission was noticeable on the one hand by changes of echo-internal structure of the tumour and liver metastases, and on the other hand by size reduction. Sonography possesses the advantage over CT that sections can be performed multidirectionally and are reproducible, for example for the purpose of documenting the largest tumour diameter. A drawback is in our opinion the lack of information supplied by the method in respect of the vascular situation within the area of malignant space-occupying growths. A valuable asset of computed tomography is the possibility of demonstrating hypervascularisation in a solid space-occupying growth by using an intravenously applied contrast medium which is easily passed through the kidneys, especially in "serial CT" procedures. This is similarly true for angiography, which, however, does not play any significant part in closely-meshed follow-up schedules because if its invasiveness. As a matter of fact, it can even simulate a florid tumour or metastasising process.
D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D010191:Pancreatic Polypeptide / Q000378:metabolism*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D010191:Pancreatic Polypeptide
Bildgebende Diagnostik bei der Remission eines metastasierten hormonbildenden Pankreaskarzinoms (PPom) unter Polychemotherapie.