DIAGNOSTIC FEATURES ON IMAGES IN PRIMARY SMALL-CELL CARCINOMA OF THE PANCREAS

Small cell carcinoma of the pancreas is a rare tumor with very poor pr ognosis, but the tumor is successfully treated by chemotherapy. Theref ore, small cell carcinoma must be differentiated from other pancreatic tumors on images. A 71-year-old man presented with digestive symptoms . Multiple hypoechoic masses were detected on transabdominal ultrasono graphy and lateral shadow and posterior echo enhancement on endoscopic ultrasonography. The dynamic computed tomography scan revealed that t he tumor walls were hypervascular at an early phase, and that the cent ral portions were gradually stained at a late phase with differences a mong the tumors; tumor stains were also found on angiography. The dist al site of the main pancreatic duct was completely interrupted, as see n on endoscopic retrograde pancreatography. The resected specimens wer e composed of circumferential hard walls and internally necrotic, hemo rrhagic contents of different degrees and were microscopically diagnos ed as small cell carcinoma. The tumor has to be differentiated from hy pervascular pancreatic tumors, especially islet cell tumors.