Solid Pancreatic Tumors: Protocols of Radiological Examinations and Differential Diagnosis (Lecture, Part 1)

Abstract

Introduction. Pancreatic tumors have solid or cystic structures. Most often in such tumors there are signs of malignancy at the time of radiological examination. Tumors can be diagnosed incidentally (incidentalomas), or at differential diagnosis with other focal pancreatic lesions. Aim. To evaluate the protocols radiological examinations and criteria for differential diagnosis. Results. Multidetector computed tomography with bolus contrast enhancement is the “gold standard” for diagnosis of pancreatic cancer, but other methods, such as MRI with DWI, endoscopic ultrasonography are increasingly used to assess operability, staging and resectability of the pancreatic tumors. The pancreatic ductal adenocarcinoma need to be differentiated from neuroendocrine tumors, solid pseudopapillary tumor, local forms of pancreatitis and other rare pancreatic solid lesions. Conclusion. MDCT is the most common diagnostic method, but any radiological method can be used. Decision about “histological” diagnosis will be, if it is confirmed by two or more radiological examinations. Pancreatic ductal adenocarcinoma is the most aggressive tumour with the lowest period of survival after surgical treatment. Accordingly, the differential diagnosis of solid pancreatic lesion is needed. There are not benign solid tumours of the pancreas. All tumours are or malignant at the time of diagnosis, or they had the potential to become malignant.