Pancreas rule 8 : Primary pancreatic tumors

¨Pancreatic Neoplasm

¨Primary pancreatic neoplasm can be sub-divided into

¨Solid tumors

¨Cystic tumors--contain fluid density due to necrosis

¨Functional tumors

¨Diagnostic landmark for pancreatic carcinoma is contour deformity. This can be seen also in focal pancreatitis but remember that focal pancreatitis is extremely rare. So , even if it is focal pancreatitis make your diagnosis pancreatic neoplasm until proven other wise by biopsy

Tumor may encase a vessel such as superior mesenteric vein resulting in attenuation or obstruction of the vessel lumen , which indicates in-operable case

Signs of pancreatic neoplasm

contour abnormalities which means focal change in size and shape

Abnormal Heterogeneous density

Duct dilatation is indication of presence of a tumor

Retention cysts if pancreas is diffusely enlarged with cysts , this appearance  is of acute pancreatitis , and the cyst is pseudo cyst, while if it is with localized pathology with cysts , this will be retention cysts

Ascites

Direct invasion to surrounding organs by pancreatic tumors

¨Cancer pancreas can invade the stomach  or other organs such as duodenum or colon, here you should see a part of the tumor inside the lumen of the invaded organ

If the tumor is just in contact with the wall of the organ this does not means direct invasion