E1669. Primary Pancreatic Malignancies Beyond Adenocarcinoma: Review of Imaging Features of Select Aggressive Pancreatic Neoplasms
  1. Dhakshinamoorthy Ganeshan; University of Texas MD Anderson Cancer Center
  2. Mohammed Saleh; University of Texas MD Anderson Cancer Center
  3. Eric Tamm; University of Texas MD Anderson Cancer Center
  4. Janio Szklaruk; University of Texas MD Anderson Cancer Center
  5. Priya Bhosale; University of Texas MD Anderson Cancer Center
Pancreatic adenocarcinoma accounts for the vast majority of all pancreatic malignancies and is a leading cause of cancer-related deaths in the United States. It is estimated that over 57,600 people will be diagnosed with pancreatic cancer and about 47,050 people will die of pancreatic cancer in the United States in 2020. While adenocarcinoma remains the most frequent malignant pancreatic tumor encountered, various other epithelial and mesenchymal malignancies may also involve the pancreas. Further, numerous inflammatory and infectious etiologies can also affect the pancreas, contributing to the diagnostic dilemma.

Educational Goals / Teaching Points
Review of multimodality imaging features of select malignant primary pancreatic neoplasms and discuss management of these tumors

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this educational exhibit, we will review imaging characteristics of several malignant epithelial and mesenchymal tumors affecting the pancreas, including pancreatic neuroendocrine tumors, acinar cell carcinoma, primary pancreatic lymphoma and sarcoma. Specific emphasis will be placed on CT imaging features such as tumor morphology (solid versus cystic), enhancement characteristics (hypervascular versus hypovascular) and pattern of metastases. Role of PET CT in the management of these tumors will be discussed.

Numerous neoplastic and non-neoplastic conditions can involve the pancreas and mimic pancreatic adenocarcinoma. Correlation of the clinical and radiological features can help narrow the differential diagnoses. An understanding of the appearance of lesions when using a multiple imaging modality approach can be helpful. Biopsy may be required for definitive diagnosis.