PMC5654295_01
(a and b) Ultrasound images. (a) Well-defined hypoechoeic lesion without necrosis or calcification (orange arrow). Mildly dilated pancreatic duct (red arrow). (b) Color Doppler evaluation showing no color flow within the lesion in the pancreas (orange arrow). (c, d, e, f, g, and h) MRI and MRCP images. (c) MRCP-Normal CBD (orange arrow). Mildly dilated pancreatic duct (red arrow). (d) T2 weighted axial image showing heterogeneous mass in the head of the pancreas (orange arrow). (e) Mildly dilated pancreatic duct (green arrow). (f) Coronal T2 weighted image showing heterogeneous mass in the head of the pancreas (orange arrow). (g) Axial T1 weighted image without contrast showing well-defined hypointense lesion in the pancreas (orange arrow). (h) Axial postcontrast image showing no enhancement of the lesion in the head of the pancreas (orange arrow).
CRIPE2017-3253787.001.jpg
PMC5654295_01_CRIPE2017-3253787.001.jpg
fig1
An abdominal ultrasound was obtained which showed a well-defined round heterogeneous mass in the head of the pancreas (Figure 1(a)) without significant vascular flow on the Doppler image (Figure 1(b)). MRI demonstrated a 2.6 x 2.6 cm pancreatic head mass (Figure 1(d)) with heterogeneous internal signal (Figures 1(f) and 1(g)) and main pancreatic duct dilatation to 3.7 mm (Figure 1(e)). There was no significant postcontrast enhancement (Figure 1(h)). The MRCP images demonstrated normal CBD and mildly dilated pancreatic duct (Figure 1(c)). which heightened suspicion for a solid pseudopapillary epithelial neoplasm or cystic endocrine tumor of the pancreas.