Neuroendocrine tumor of the pancreas.

HISTORY: Pancreatic tail mass on outside CT scan.

FINDINGS: Images 1-3 are transverse scans of the left lobe of the liver

demonstrating diffuse heterogeneity and alteration in the normal

parenchymal echogenicity.  Notice in Image 1 there is bulging of the

contour of the liver due to an echogenic mass.

Images 4, 5, and 6 are a contrast-enhanced CT scans of the liver and

pancreas demonstrating multiple hepatic lesions and a calcified mass in

the tail of the pancreas.

 

DIAGNOSIS: Multifocal hepatoma.  Calcified neuroendocrine tumor of the

pancreas.

DISCUSSION: This case illustrates the fact that well defined areas of

tumor on contrast CT may appear quite ill defined on ultrasound.  On

contrast CT, note the peripheral enhancing rim around the left lobe

lesions.  The calcified pancreatic mass was not well imaged with

sonography due to its location in the tail in the pancreas.

Calcification is rarely seen in ductal adenocarcinomas of the focal

hepatic lesions.  Differential diagnosis includes multifocal hepatoma,

metastatic carcinoma, and neuroendocrine tumor.