74-year-old man with tumor in pancreatic tail on screening US. Answer


74-year-old man with tumor in pancreatic tail on screening US.



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Key words: Pancreatic metastases, 膵転移、Renal cell carcinoma, RCC, 腎細胞癌、腎癌、腎癌膵転移、RCC, diffusion, ADC map

Key images:

Plain CT1Dynamic CT early 1Dynamic CT delay 1MRCP1T2WI 1T2WI coronal 1T1WI FS1MRI dynamic early 1MRI dynamic portal 1DWI ADCADC mapPET CT1


Clinical features, Prognosis

1. Song SW, Cheng JF, Liu N, Zhao TH.

Diagnosis and treatment of pancreatic metastases in 22 patients: a retrospective study.WorldJ SurgOncol. 2014 Sep 25;12:299.

2. SellnerF, Tykalsky N, De Santis M, et al.

Solitary and multiple isolated metastases of clear cell renal carcinoma to thepancreas: an indication for pancreatic surgery.

Ann SurgOncol. 2006 Jan;13(1):75-85. Epub 2006 Jan 1.

3. ZerbiA, Ortolano E, Balzano G, et al.

Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection?Ann SurgOncol. 2008 Apr;15(4):1161-8.

4. Law CH, Wei AC, Hanna SS,  et al.

Pancreatic resection for metastatic renal cell carcinoma: presentation, treatment, and outcome. Ann Surg Oncol.2003 Oct;10(8):922-6.

5. Sohn TA, Yeo CJ, Cameron JL, et al.

Renal cell carcinoma metastatic to the pancreas: results of surgical management.J GastrointestSurg.2001 Jul-Aug;5(4):346-51.

6. Faure JP, Tuech JJ, Richer JP, et al.

Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival. J Urol. 2001 Jan;165(1):20-2.

7. AkatsuT, Shimazu M, Aiura K, et al.

Clinicopathological features and surgical outcome of isolated metastasis of renal cell carcinoma. Hepatogastroenterology. 2007 Sep;54(78):1836-40.

Imaging features

1. Ng CS, Loyer EM, Iyer RB, David CL, DuBrow RA, Charnsangavej C.

Metastases to the pancreas from renal cell carcinoma: findings on three-phase contrast-enhanced helical CT. AJRAm J Roentgenol. 1999 Jun;172(6):1555-9.

2. Klein KA, Stephens DH, Welch TJ.

CT characteristics of metastatic disease of the pancreas. Radiographics. 1998 Mar-Apr;18(2):369-78.

3. VincenziM, Pasquotti G, Polverosi R, et al.
Imaging of pancreatic metastases from renal cell carcinoma. Cancer Imaging. 2014 Apr 22;14:5.

4. PalmowskiM, Hacke N, Satzl S, et al.

Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology. 2008;8(2):199-203.

5. AscentiG, Visalli C,  Genitori A, et al.

Multiple hypervascular pancreatic metastases from renal cell carcinoma: dynamic MR and spiral CT in three cases. Clin Imaging. 2004 Sep-Oct;28(5):349-52.

6. Tsitouridis I, Diamantopoulou A, Michaelides M, et al.

Pancreatic metastases: CT and MRI findings. DiagnIntervRadiol. 2010 Mar;16(1):45-51.

RCC and ADC value

1. Choi YA, Kim CK, Park SY, et al.

Subtype differentiation of renal cell carcinoma using diffusion-weighted and blood oxygenation level-dependent MRI.AJR Am J Roentgenol. 2014 Jul;203(1):W78-84.

2. SasamoriH, Saiki M, Suyama J, et al.

Utility of apparent diffusion coefficients in the evaluation of solid renal tumors at 3T. MagnReson Med Sci. 2014;13(2):89-95.

3. Sevcenco S, Heinz-Peer G, Ponhold L, et al.

Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors. EurJ Radiol. 2014 Jun;83(6):909-13.

4. Yu X, Lin M, Ouyang H, et al.

Application of ADC measurement in characterization of renal cell carcinomas with different pathological types and grades by 3.0T diffusion-weighted MRI.

EurJ Radiol. 2012 Nov;81(11):3061-6.

5. PaudyalB, Paudyal P, Tsushima Y, et al.

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI. Br J Radiol. 2010 Apr;83(988):336-43.


1. Win AZ, Aparici CM.

Clinical effectiveness of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography in management of renal cell carcinoma: a single institution experience. World J Nucl Med. 2015 Jan-Apr;14(1):36-40.

2. Sharma P, Karunanithi S, Chakraborty PS, et al.

18F-Fluoride PET/CT for detection of bone metastasis in patients with renal cell carcinoma: a pilot study. NuclMed Commun. 2014 Dec;35(12):1247-53.

3. Lee H, Hwang KH, Kim SG, et al.

Can Initial (18)F-FDG PET-CT Imaging Give Information on Metastasis in Patients with Primary Renal Cell Carcinoma? NuclMed Mol Imaging. 2014 Jun;48(2):144-52.

4. Fuccio C, Ceci F, Castellucci P, et al.

Restaging clear cell renal carcinoma with 18F-FDG PET/CT. ClinNucl Med. 2014 Jun;39(6):e320-4.

5. Chen JL, Appelbaum DE, Kocherginsky M, et al.

FDG-PET as a predictive biomarker for therapy with everolimus in metastatic renal cell cancer. Cancer Med. 2013 Aug;2(4):545-52.

6. Nakhoda Z, Torigian DA, Saboury B, et al.

Assessment of the diagnostic performance of (18)F-FDG-PET/CT for detection and characterization of solid renal malignancies. Hell J Nucl Med. 2013 Jan-Apr;16(1):19-24.

7. Wang HY, Ding HJ, Chen JH, et al.

Meta-analysis of the diagnostic performance of [18F]FDG-PETand PET/CT in renal cell carcinoma. Cancer Imaging. 2012 Oct 26;12:464-74.

8. Namura K, Minamimoto R, Yao M, et al.

Impact of maximum standardized uptake value (SUVmax) evaluated by 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) on survival for patients with advanced renal cell carcinoma: a preliminary report. BMC Cancer. 2010 Dec 3;10:667.

9. Mueller-Lisse UG, Mueller-Lisse UL.

Imaging of advanced renal cell carcinoma. World J Urol. 2010 Jun;28(3):253-61.

10. Rodríguez Martínez de Llano S, Jiménez-Vicioso A, et al.

Clinical impact of (18)F-FDG PET in management of patients with renal cell carcinoma.

Rev Esp Med Nucl. 2010 Jan-Feb;29(1):12-9.

11. Staging of renal cell carcinoma.

Mueller-Lisse UG, Mueller-Lisse UL, Meindl T, et al. EurRadiol. 2007 Sep;17(9):2268-77.

12. Ak I, Can C.

F-18 FDG PET in detecting renal cell carcinoma. ActaRadiol. 2005 Dec;46(8):895-9.