Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI.
OBJECTIVE
To investigate the characteristics of metastasis to the pancreas using computed tomography (CT) and magnetic resonance imaging (MRI).


METHODS
Twenty-two patients with metastases to the pancreas were examined preoperatively by MRI (7/22) and/or multidetector CT (15/22). Pre- and post-contrast images were acquired and morphology, size, and contrast enhancement of the tumor analyzed. Subsequently, all patients underwent surgery, and the histopathologic findings were compared with the imaging results.


RESULTS
In 22 patients, a total of 29 metastases were found on CT and MRI. These metastases originated from renal cell carcinomas (RCC; 22/29), colorectal carcinoma (3/29), and other malignancies (4/29). The metastases differed not in size or location, but in their contrast enhancement characteristics. RCC metastases had either intense homogeneous enhancement (in small lesions) or rim enhancement (in large lesions). Outer regions of colorectal metastases showed no difference from normal pancreatic tissue, whereas the inner area showed hypo-enhancement due to central necrosis.


CONCLUSIONS
Imaging features of metastases from RCC point to their primary origin. While they can be distinguished from primary adenocarcinoma of the pancreas, differentiation from endocrine carcinoma might be difficult. Differentiation of colorectal carcinoma remains to be investigated on larger numbers of cases.
Palmowski
Moritz
M
Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.
Hacke
Nicola
N
Satzl
Stefanie
S
Klauss
Miriam
M
Wente
Moritz N
MN
Neukamm
Martin
M
Kleeff
Joerg
J
Hallscheidt
Peter
P
D002292:Carcinoma, Renal Cell / Q000556:secondary; D015179:Colorectal Neoplasms / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed