Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report

Context. One of the characteristic findings of intraductal papillary mucinous neoplasms (IPMN) is the presence of a direct communication between the lesion and the ductal pancreatic system and when magnetic resonance cholangiopancreatography (MRCP) shows uncertain findings, it is useful to perform a...

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Bibliographic Details
Main Authors: Elsa Iannicelli, Francesco Carbonetti, Marco Di Pietropaolo, Giulia Francesca Federici, Gabriele Capurso, Vincenzo David
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Radiology
Online Access:http://dx.doi.org/10.1155/2014/820359
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Summary:Context. One of the characteristic findings of intraductal papillary mucinous neoplasms (IPMN) is the presence of a direct communication between the lesion and the ductal pancreatic system and when magnetic resonance cholangiopancreatography (MRCP) shows uncertain findings, it is useful to perform a MRCP after secretin stimulation (MRCP-S) which provides a better visualization of the ductal system. Case Report. We present a case of 51-year-old man in whom, during a CT follow-up for a renal tumour, was found a cystic lesion of the pancreas. To better evaluate the lesion and its suspected communication with the pancreatic system, MR with gadolinium and MRCP and MRCP-S were performed. With the MRCP and MRI it was not possible to identify a clear communication between the cystic lesion and the ductal system. MRCP-S showed an increase in signal intensity of the lesion and its communication with the ductal system, allowing us to classify the cystic lesion as a main duct in intraductal papillary mucinous neoplasm. The patient underwent a surgical duodenal pancreatectomy. The histological result of the specimen confirmed the diagnosis of adenocarcinoma IPMN. Conclusion. In this case MRCP-S has allowed a clearer identification of the cystic lesion allowing a correct diagnosis and treatment.
ISSN:2090-6862
2090-6870