Imaging features of undifferentiated carcinoma of the pancreas

Authors: Kousei Ishigami, Akihiro Nishie, Takeo Yamamoto, Yoshiki Asayama, Yasuhiro Ushijima, Daisuke Kakihara, Nobuhiro Fujita, Koichiro Morita, Takao Ohtsuka, Ken Kawabe, Naoki Mochidome, Hiroshi Honda


Introduction
The purpose of this retrospective study was to evaluate imaging features of undifferentiated carcinoma of the pancreas.

Methods
The study group included eight patients with surgically resected undifferentiated carcinoma of the pancreas. Multidetector‐row computed tomography (MDCT, n = 8) and magnetic resonance imaging (MRI, n = 6) findings were retrospectively reviewed.

Results
On MDCT, all eight cases were hypovascular with upstream main pancreatic duct (MPD) dilatation, and only 1 showed exophytic growth. Five cases (62.5%) showed necrosis/cystic change, and calcification was observed in two cases (25%). Calcification reflected tumour osteoid components. On MRI, haemorrhage and hemosiderin were observed in 4 of 6 (66.7%) cases. In addition, tumour thrombus in the splenic vein (n = 1) and intraductal tumour growth in the MPD (n = 2) were pathologically identified, although imaging studies only revealed 1 of these latter cases.

Conclusion
Undifferentiated carcinoma of the pancreas may present as a tumour with haemorrhagic necrosis. Coexistence of calcification, intraductal tumour growth in the MPD and tumour thrombus may support the imaging diagnosis of this entity.