Multidetector computed tomography in the study of pancreatic metastases

The aim of this study was to explore the diagnostic performance of multidetector computed tomography (MDCT) in characterising pancreatic metastases. CT examinations of 17 patients affected by pancreatic metastases were retrospectively reviewed. The primary malignancy was renal cell carcinoma (RCC) in eight cases, uterine leiomyosarcoma in two, lung carcinoma in four and breast carcinoma in three. CT images were assessed for lesion number, size and morphology. Pancreatic lesions were solitary in seven cases and multiple in ten. Lesion size ranged between 8 and 40 mm. Metastases from RCC were hyperattenuating in the arterial phase, metastases from breast cancer and lung cancer were hypoattenuating and metastases from uterine leiomyosarcoma were inhomogeneous. Precise lesion characterisation was obtained by using CT examination in 12 cases. In the remaining five patients, all with solitary metastases from RCC, a precise diagnosis was not possible because the lesions could not be differentiated from a neuroendocrine tumour. MDCT allowed pancreatic metastases characterisation in 70.5% of cases. The lesions were the manifestation of widely disseminated neoplastic disease, with the exception of metastases from RCC, which were exclusively located in the pancreas.