title: Contrast-enhanced multiphasic CT and MRI findings of adenosquamous carcinoma of the pancreas.
abstract: OBJECTIVE
  The objective was to retrospectively study computed tomography (CT) and magnetic resonance imaging (MRI) findings of adenosquamous carcinoma of the pancreas (PASC).
  
  
  METHODS
  Twelve patients (six women and six men; mean age, 61.3 years; range, 47-78 years) who presented with PASC as documented by pathologic examination underwent CT (n=10) or both CT and MRI (n=2) examination. Two radiologists evaluated the images and determined the location, size, margin, internal attenuation or signal intensity, contrast enhancement, and pattern for each tumor. Additionally, the presence of poorly enhanced areas, upstream main pancreatic duct (MPD) dilatation, pancreatic atrophy, and peripancreatic tissue metastasis were evaluated. Images were cross-referenced to surgical and pathologic findings.
  
  
  RESULTS
  Masses were distributed throughout the pancreas (head, n=6; body, n=1; and tail, n=5). The tumor size ranged from 2.4 to 5.5 cm with an average size of 3.7 cm. Eight (66.7%) masses were ill defined, and seven (58.3%) were partially exophytic. Twelve (100%) masses showed heterogeneous and poorly enhanced areas. The lesions showed weak (n=5), moderate (n=5), or intense (n=2) progressive enhancement. The diameter of MPD in six patients ranged from 3.0 to 5.0 mm with an average of 3.7 mm. Pancreatic atrophy was not found. In 10 patients (83.3%), masses invaded the peripancreatic tissues. Two patients had metastatic liver disease at presentation.
  
  
  CONCLUSIONS
  PASC typically presented as an ill-defined, hypovascular mass with a poorly enhanced area, exophytic tendency, and peripancreatic tissue invasion. Lack of pancreatic atrophy and mild MPD dilatation were also distinct from common duct pancreatic adenocarcinoma.
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging, Institute, Shanghai 200032, People's Republic of China; Department of Medical Imaging, Shanghai Medical School of Fudan University, Shanghai, 200032, People's Republic of China.
authors.forename: Yuqin
authors.initials: Y
authors.lastname: Ding
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhou
authors.forename: Huihong
authors.initials: H
authors.lastname: Sun
authors.forename: Deming
authors.initials: D
authors.lastname: He
authors.forename: Mengsu
authors.initials: M
authors.lastname: Zeng
authors.forename: Shengxiang
authors.initials: S
authors.lastname: Rao
mesh_terms: D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Adenosquamous carcinoma; Magnetic resonance imaging; Pancreas; X-ray computed tomography