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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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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author Elsa Iannicelli
Francesco Carbonetti
Marco Di Pietropaolo
Giulia Francesca Federici
Gabriele Capurso
Vincenzo David
author_facet Elsa Iannicelli
Francesco Carbonetti
Marco Di Pietropaolo
Giulia Francesca Federici
Gabriele Capurso
Vincenzo David
author_sort Elsa Iannicelli
collection DOAJ
description 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.
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spelling doaj-art-5ef4abf88a2545b09de935b9505bde972025-08-20T03:34:22ZengWileyCase Reports in Radiology2090-68622090-68702014-01-01201410.1155/2014/820359820359Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case ReportElsa Iannicelli0Francesco Carbonetti1Marco Di Pietropaolo2Giulia Francesca Federici3Gabriele Capurso4Vincenzo David5Sant’Andrea Hospital, Rome, Department of Radiology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, ItalySant’Andrea Hospital, Rome, Department of Radiology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, ItalySant’Andrea Hospital, Rome, Department of Radiology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, ItalySant’Andrea Hospital, Rome, Department of Radiology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, ItalySant’Andrea Hospital, Rome, Department of Gastroenterology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, ItalySant’Andrea Hospital, Rome, Department of Radiology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, ItalyContext. 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.http://dx.doi.org/10.1155/2014/820359
spellingShingle Elsa Iannicelli
Francesco Carbonetti
Marco Di Pietropaolo
Giulia Francesca Federici
Gabriele Capurso
Vincenzo David
Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report
Case Reports in Radiology
title Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report
title_full Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report
title_fullStr Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report
title_full_unstemmed Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report
title_short Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report
title_sort magnetic resonance cholangiopancreatography with secretin stimulation in the diagnosis of intraductal papillary mucinous neoplasm a paradigmatic case report
url http://dx.doi.org/10.1155/2014/820359
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