title: Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma.
abstract: Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. 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. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved by somatostatin-receptor scintigraphy (SRS). 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 (Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT (Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure (3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Camera
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Severino
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Antongiulio
authors.initials: A
authors.lastname: Faggiano
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Masone
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Gelsomina
authors.initials: G
authors.lastname: Mansueto
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Maurea
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Fonti
authors.affiliation: Luigi Camera, Rosa Severino, Simone Maurea, Marco Salvatore, Department of Advanced Biomedical Sciences, Diagnostic Imaging Section, University "Federico II", 80131 Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
keywords: Contrast induced nephropathy; Magnetic resonance imaging; Multi-detector computed tomography; Nephrogenic systemic fibrosis; Pancreatic endocrine tumor; Somatostatin receptor scintigraphy; Vasoactive intestinal peptide