A case of pancreatic hamartoma with characteristic radiological findings: radiological-pathological correlation

Kenji Toyama, Yohji Matsusaka, Shigeo Okuda, Eisuke Miura, Naoto Kubota, Yohei Masugi, Minoru Kitago, Shutaro Hori, Takahiro Yokose, Masahiro Shinoda, Michiie Sakamoto, Masahiro Jinzaki

Research output: Contribution to journalArticle

Abstract

Pancreatic hamartoma is a rare benign tumor. Its preoperative diagnosis is challenging. We present a case of pancreatic hamartoma whose radiological-pathological correlation was evaluated in detail. A 53-year-old man was referred to our institution for diagnosis and treatment. Contrast-enhanced computed tomography (CT) and magnetic resonance image revealed a 3.5 cm long tumor arising from the head of the pancreas with cystic and solid components, the latter of which was gradually and inhomogeneously enhanced in the delayed phase. Fluorodeoxyglucose (FDG) positron emission tomography/CT revealed slight FDG uptake in the solid component. Histologically, a number of pancreatic lobule-like structures, which were mainly composed of aggregates of small ducts embedded in concentric fibrous stroma with no apparent islets or peripheral nerves, were observed in the solid component, whereas multiple dilated ducts were seen in the cystic region. The solid component also contained a narrow area of edematous fibrous stroma with low vessel density, which corresponded with the unenhanced part in the inhomogeneously enhanced solid component. There was no remarkable cytological atypia throughout the mass. A pathological diagnosis of pancreatic hamartoma was made. The radiological findings agree well with the pathological findings. When a pancreatic tumor is of the solid type, preoperatively diagnosing it as pancreatic hamartoma is not possible. However, when a pancreatic tumor with cystic and solid components is inhomogeneously enhanced in contrast-enhanced studies, a diagnosis of pancreatic hamartoma can be considered.

Original languageEnglish
JournalAbdominal Radiology
DOIs
Publication statusAccepted/In press - 2020 Jan 1

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Keywords

  • Computed tomography
  • Diagnosis
  • Hamartoma
  • Magnetic resonance imaging
  • Pancreas
  • Positron emission tomography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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