[Long-term follow-up and therapeutic control of a hepatic metastatic acinar cell carcinoma of the pancreas using FDG PET].

Klinik für Nuklearmedizin des Zentrums der Radiologie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Deutschland.
Nuklearmedizin (Impact Factor: 1.49). 09/1998; 37(5):187-91.
Source: PubMed


A 33 years old woman presented with cramp-like abdominal pain. Ultrasound examination revealed multiple lesions in the liver of hyper- and hypoechoic echogenicity which in accordance to subsequently performed computed tomography and dynamic hepatobiliary scintigraphy were considered to be a focal nodular hyperplasia (FNH). A severe increase of the serum lipase concentration, suspected to be an acute pancreatitis, was treated conservatively and led to a short improvement of symptoms. Some months later, a severe progression of the pain symptoms occurred, along with a measurable expansion of the abdominal circumference and palpable tumors of the liver. The dynamic hepatobiliary imaging and the static liver scan showed a decreased perfusion and function of the nodes as well as a reduced RES activity, respectively. A subsequently performed Positron Emission Tomography (PET) with F-18-Fluorodeoxyglucose (FDG) showed a massively increased glucose metabolism of the liver tumors. The histologic result of several biopsies of the tumors revealed metastases of an acinus cell carcinoma of the pancreas. Under systemic and local chemotherapy, a temporary remission could be obtained that was clearly detectable in a second FDG-PET. Nevertheless, during the further course of the disease, a progression occurred being detectable in an additional control PET-study by an increase in tumor size as well as in tumor glucose metabolism. The patient died in liver coma 15 months after the histologic diagnosis was obtained.

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Available from: Thomas Rink, Sep 26, 2014
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    ABSTRACT: The pancreas is a complex organ playing both exocrine and endocrine roles and subject to a variety of diseases with diverse and sometimes overlapping imaging characteristics. The broad spectrum of pancreatic disease includes both inflammatory and neoplastic processes including but not limited to acute or chronic pancreatitis, adenocarcinoma, neuroendocrine tumors, and other neoplasms, ranging from benign serous cystadenomas to malignant mucinous cystadenomas and from lymphoma to metastasis. When pancreatic malignancy is suspected or known, multiple diagnostic imaging modalities may be considered for initial diagnosis, staging, determination of resectability, monitoring treatment response, and detecting recurrence (Buck et al. 2011).
    Abdominal Imaging, 01/2013: pages 1319-1336; , ISBN: 978-3-642-13326-8