CT and MRI features of undifferentiated carcinomas with osteoclast-like giant cells of the pancreas: a case series

• Published in: Abdominal imaging Vol. 44; no. 4; pp. 1246 - 1255
• Main Authors: Fukukura, Yoshihiko, Kumagae, Yuichi, Hirahara, Mitsuho, Hakamada, Hiroto, Nagano, Hiroaki, Nakajo, Masanori, Kamimura, Kiyohisa, Nakajo, Masatoyo, Higashi, Michiyo, Yoshiura, Takashi
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2019; Springer Nature B.V
• Subjects: Attenuation; Biocompatibility; Biopsy; Carcinoma; CARCINOMAS; Computed tomography; COMPUTERIZED TOMOGRAPHY; Gastroenterology; Giant cells; HEMOSIDERIN; Hepatology; Histology; Imaging; Informed consent; Magnetic resonance imaging; Medical imaging; Medical records; Medicine; Medicine & Public Health; NMR; NMR IMAGING; Nuclear magnetic resonance; PANCREAS; Pancreatic cancer; Patients; Portal vein; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; REVIEWS; Special Section: Distinguished Papers from JSAR; TUMOR CELLS; Tumors; VEINS; Undifferentiated carcinoma; Pancreatic neoplasm; Magnetic resonance imaging; Multidetector computed tomography
• ISSN: 2366-004X; 2366-0058; 2366-0058
• DOI: 10.1007/s00261-019-01958-9

Purpose The purpose of this case series was to describe computed tomography (CT) and magnetic resonance imaging (MRI) features of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. Methods Institutional ethics review board approval was obtained, and informed consent was waived for this case series. We reviewed CT and MRI of patients with pathologically confirmed undifferentiated carcinoma with osteoclast-like giant cells of the pancreas found in the medical records of our hospital between 2006 and 2016. Results Seven patients (3 males and 4 females; age, 59–82 years (mean, 71)) with confirmation by surgical resection ( n  = 3) or biopsy ( n  = 4) were identified. They underwent CT ( n  = 7) and MRI ( n  = 6). The tumors 26–83 mm in diameter (mean, 44 mm) were located in the head ( n  = 4) or body ( n  = 3) of the pancreas. They were demonstrated as lower attenuation areas relative to the adjacent pancreas on CT images obtained in both pancreatic and portal vein phases ( n  = 7) with a well-defined smooth margin ( n  = 5). They were demonstrated as hypointense areas relative to the pancreas on T2-weighted images ( n  = 4) and T2*-weighted images ( n  = 4) and diffusion-weighted images ( n  = 3). They contained hemosiderin deposits on histology ( n  = 7). Conclusions Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas might be present as low attenuation areas with a well-defined smooth margin on CT images obtained in pancreatic and portal vein phases, and hypointense areas on T2-, T2*-, and diffusion-weighted images caused by hemosiderin deposits.