ARRS 2022 Abstracts


E2154. A Wolf in Sheep’s Clothing: Malignant Mimickers of Benignity in Gastrointestinal Imaging
  1. Antonia Gurney; University of Nebraska Medical Center
  2. Elizabeth Edney; University of Nebraska Medical Center
  3. Elon Granader; University of Nebraska Medical Center
  4. Ryan Downey; University of Nebraska Medical Center
A myriad of malignant lesions of the gastrointestinal system can masquerade as common benign findings on CT and MRI. Consequently, the radiologist must be aware of these potential pitfalls so that malignancy does not go undiagnosed, and patients receive appropriate treatment.

Educational Goals / Teaching Points
This educational exhibit will review malignant lesions that may simulate benignity by location: liver, biliary system, pancreas, spleen, gastrointestinal tract, peritoneum/mesentery, and abdominal wall. The specific imaging features that should raise suspicion for underlying malignancy rather than a non-neoplastic process will be emphasized. Additionally, clinical situations that may suggest a malignant etiology for a particular patient presentation will be described. Situations when biopsy or surgical excision are necessary to make a definitive diagnosis will be reviewed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Representative examples of malignant lesions simulating benign lesions on CT and MRI will be shown. Subtle but critical differentiating imaging features and clinical presentations of malignant from benign lesions will be emphasized. Situations when biopsy or surgical excision are ultimately necessary for definitive diagnosis will also be discussed.

A number of malignancies in the abdomen and pelvis can simulate benign disease. Familiarity with the spectrum of malignant processes masquerading as benign lesions is crucial to make the correct diagnosis and ensure proper patient care.