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Calcified pancreatic and peripancreatic neoplasms: spectrum of pathologies

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Abstract

A variety of pancreatic and peripancreatic neoplasms may contain calcifications. We present a review of common to uncommon pancreatic neoplasms that may contain calcifications to include ductal adenocarcinoma, pancreatic neuroendocrine tumors, serous cystadenomas, solid pseudopapillary tumors, intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, and lymphoepithelial cysts. In addition, duodenal mucinous adenocarcinoma can present as a peripancreatic mass that may contain calcification. Knowledge of the spectrum of calcification patterns can help the interpreting radiologist provide a meaningful differential.

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References

  1. National Cancer Institute. SEER cancer statistics factsheets: pancreas cancer. http://seer.cancer.gov/statfacts/html/pancreas.html. Accessed 11 Nov 2016.

  2. Pietryga JA, Morgan DE (2015) Imaging preoperatively for pancreatic adenocarcinoma. J Gastrointest Oncol 6(4):343–357

    PubMed  PubMed Central  Google Scholar 

  3. Mohamed A Jr, Ayav A, Belle A, et al. (2017) Pancreatic cancer in patients with chronic calcifying pancreatitis: computed tomography findings—a retrospective analysis of 48 patients. Eur J Radiol 86:206–212

    Article  PubMed  Google Scholar 

  4. Niederle MB, Hackl M, Kaserer K, Niederle B (2010) Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European Neuroendocrine Tumour Society classification: an analysis based on prospectively collected parameters. Endocr Relat Cancer 17(4):909–918

    Article  PubMed  Google Scholar 

  5. Halfdanarson TR, Rubin J, Farnell MB, Grant CS, Petersen GM (2008) Pancreatic endocrine neoplasms: epidemiology and prognosis of pancreatic endocrine tumors. Endocr Relat Cancer 15(2):409–427

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hruban RH, Pitman MB, Klimstra DS (2007) Endocrine Neoplasms. In: Hruban RH, Pitman MB, Klimstra DS (eds) Tumors of the pancreas: AFIP atlas of tumor pathology, vol. 251, 4th edn. Washington DC: American Registry of Pathology

    Google Scholar 

  7. Metz DC, Jensen RT (2008) Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology 135(5):1469–1492

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Lesniak RJ, Hohenwalter MD, Taylor AJ (2002) Spectrum of causes of pancreatic calcifications. AJR Am J Roentgenol 178(1):79–86

    Article  PubMed  Google Scholar 

  9. Poultsides GA, Huang LC, Chen Y, et al. (2012) Pancreatic neuroendocrine tumors: radiographic calcifications correlate with grade and metastasis. Ann Surg Oncol 19(7):2295–2303

    Article  PubMed  Google Scholar 

  10. Sarr MG, Murr M, Smyrk TC, et al. (2003) Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions. J Gastrointest Surg 7(3):417–428

    Article  PubMed  Google Scholar 

  11. Curry CA, Eng J, Horton KM, et al. (2000) CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment? AJR Am J Roentgenol 175(1):99–103

    Article  CAS  PubMed  Google Scholar 

  12. Perez-Ordonez B, Naseem A, Lieberman PH, Klimstra DS (1996) Solid serous adenoma of the pancreas. The solid variant of serous cystadenoma? Am J Surg Pathol 20(11):1401–1405

    Article  CAS  PubMed  Google Scholar 

  13. Bosman F (2010) WHO classification of tumours of the digestive system, 4th edn. Lyon: IARC Press

    Google Scholar 

  14. Papavramidis T, Papavramidis S (2005) Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. J Am Coll Surg 200(6):965–972

    Article  PubMed  Google Scholar 

  15. Lam KY, Lo CY, Fan ST (1999) Pancreatic solid-cystic-papillary tumor: clinicopathologic features in eight patients from Hong Kong and review of the literature. World J Surg 23(10):1045–1050

    Article  CAS  PubMed  Google Scholar 

  16. Buetow PC, Buck JL, Pantongrag-Brown L, et al. (1996) Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology 199(3):707–711

    Article  CAS  PubMed  Google Scholar 

  17. Baek JH, Lee JM, Kim SH, et al. (2010) Small (< or = 3 cm) solid pseudopapillary tumors of the pancreas at multiphasic multidetector CT. Radiology 257(1):97–106

    Article  PubMed  Google Scholar 

  18. Adsay NV, Hasteh F, Cheng JD, et al. (2002) Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Mod Pathol 15(5):492–501

    Article  PubMed  Google Scholar 

  19. Ferrone CR, Correa-Gallego C, Warshaw AL, et al. (2009) Current trends in pancreatic cystic neoplasms. Arch Surg 144(5):448–454

    Article  PubMed  PubMed Central  Google Scholar 

  20. Adsay V, Mino-Kenudson M, Furukawa T, et al. (2016) Pathologic evaluation and reporting of intraductal papillary mucinous neoplasms of the pancreas and other tumoral intraepithelial neoplasms of pancreatobiliary tract: recommendations of Verona Consensus Meeting. Ann Surg 263(1):162–177

    Article  PubMed  PubMed Central  Google Scholar 

  21. Anand N, Sampath K, Wu BU (2013) Cyst features and risk of malignancy in intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Clin Gastroenterol Hepatol 11(8):913–921 (quiz e59–60)

    Article  PubMed  Google Scholar 

  22. Tanaka M, Fernandez-del Castillo C, Adsay V, et al. (2012) International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 12(3):183–197

    Article  PubMed  Google Scholar 

  23. Zapiach M, Yadav D, Smyrk TC, et al. (2004) Calcifying obstructive pancreatitis: a study of intraductal papillary mucinous neoplasm associated with pancreatic calcification. Clin Gastroenterol Hepatol 2(1):57–63

    Article  PubMed  Google Scholar 

  24. Kalaitzakis E, Braden B, Trivedi P, Sharifi Y, Chapman R (2009) Intraductal papillary mucinous neoplasm in chronic calcifying pancreatitis: egg or hen? World J Gastroenterol 15(10):1273–1275

    Article  PubMed  PubMed Central  Google Scholar 

  25. Perez-Johnston R, Narin O, Mino-Kenudson M, et al. (2013) Frequency and significance of calcification in IPMN. Pancreatology 13(1):43–47

    Article  CAS  PubMed  Google Scholar 

  26. Nilsson LN, Keane MG, Shamali A, et al. (2016) Nature and management of pancreatic mucinous cystic neoplasm (MCN): a systematic review of the literature. Pancreatology 16(6):1028–1036

    Article  PubMed  Google Scholar 

  27. Goh BK, Tan YM, Kumarasinghe MP, Ooi LL (2005) Mucinous cystic tumor of the pancreas with ovarian-like mesenchymal stroma in a male patient. Dig Dis Sci 50(11):2170–2177

    Article  PubMed  Google Scholar 

  28. Zamboni G, Scarpa A, Bogina G, et al. (1999) Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. Am J Surg Pathol 23(4):410–422

    Article  CAS  PubMed  Google Scholar 

  29. Grogan JR, Saeian K, Taylor AJ, et al. (2001) Making sense of mucin-producing pancreatic tumors. AJR Am J Roentgenol 176(4):921–929

    Article  CAS  PubMed  Google Scholar 

  30. de Lima JE, Jr Javitt MC, Mathur SC (1999) Mucinous cystic neoplasm of the pancreas. Radiographics 19(3):807–811

    Article  PubMed  Google Scholar 

  31. Kim WH, Lee JY, Park HS, et al. (2013) Lymphoepithelial cyst of the pancreas: comparison of CT findings with other pancreatic cystic lesions. Abdom Imaging 38(2):324–330

    Article  PubMed  Google Scholar 

  32. Mege D, Gregoire E, Barbier L, Del Grande J, Le Treut YP (2014) Lymphoepithelial cyst of the pancreas: an analysis of 117 patients. Pancreas 43(7):987–995

    Article  CAS  PubMed  Google Scholar 

  33. Kavuturu S, Sarwani NE, Ruggeiro FM, et al. (2013) Lymphoepithelial cysts of the pancreas. Can preoperative imaging distinguish this benign lesion from malignant or pre-malignant cystic pancreatic lesions? JOP 14(3):250–255

    PubMed  Google Scholar 

  34. Neugut AI, Jacobson JS, Suh S, Mukherjee R, Arber N (1998) The epidemiology of cancer of the small bowel. Cancer Epidemiol Biomark Prev 7(3):243–251

    CAS  Google Scholar 

  35. Bilimoria KY, Bentrem DJ, Wayne JD, et al. (2009) Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 249(1):63–71

    Article  PubMed  Google Scholar 

  36. Aparicio T, Zaanan A, Mary F, et al. (2016) Small bowel adenocarcinoma. Gastroenterol Clin North Am 45(3):447–457

    Article  PubMed  Google Scholar 

  37. Chae MJ, Baek IH, Oh YM, et al. (2015) A patient with duodenal mucinous adenocarcinoma presenting as a laterally spreading tumor. Clin Endosc 48(4):336–339

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Johns Hopkins University, 601 N Caroline St, Ste 3235A, Baltimore, MD, 21287, USA

    Franco Verde & Elliot K. Fishman

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  1. Franco Verde
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  2. Elliot K. Fishman
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Correspondence to Franco Verde.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Verde, F., Fishman, E.K. Calcified pancreatic and peripancreatic neoplasms: spectrum of pathologies. Abdom Radiol 42, 2686–2697 (2017). https://doi.org/10.1007/s00261-017-1182-8

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