Multislice CT reveals previously unseen mets in RCC

Purpose

The growing use of MSCT in the follow-up of oncologic patients allows early detection of very small pancreatic lesions and particularly of secondary neoplasms.

Material and Methods

We present three cases of pancreatic metastases from clear renal carcinoma confirmed with 64-row MSCT and with histological confirmation of primary RCC and related metastases.

Results

In larger lesions, intravascular contrast administration reveals the differentiation between hypercellular periphery and internal hypodense portions. The hypercellular regions are less vacularized (Figures 1 and 2).

Smaller lesions, seen by more enhancement on arterial phase, were visible as a small spot of extraductal iodine hyperimpregnation and showed a persistence of iodine staining on later scans. Histologically, these demonstrate a prevalence of microvessels and hypercellularity with reduced interstitial anarchy (Figures 3, 4, 5).

Conclusion

It’s probable that the use of recent MSCT scanners, with their superior spatial and temporal resolution, reveals small pancreatic lesions that formerly were missed. In these patients subsequent surgical and medical treatment results in high survival, but makes radiological follow-up extremely important.


Dr. M. Marasà is with the Institute of Radiology at the University of Palermo in Italy; Dr. Dav ì is with the Operative Unit of Vascular and Interventional Radiology at ARNAS-Civico Hospita in Palermo; and Dr. S. Marasà is with the Institute of Pathologic Anatomy at the University of Palermo.