Pancreatic metastases of renal cell carcinomas - evaluation of the contrast behavior at echo-enhanced power-Doppler sonography in comparison to primary pancreatic tumors

Background: Renal cell carcinomas are the most common primary tumors leadin g to pancreatic metastases. The differentiation of metastases from primary pancreatic tumors is important for the prognosis. Echo-enhanced power-Doppl er sonography may be used for the differential diagnosis of tumors. In this study, the contrast behavior of metastases of renal cell carcinomas was ev aluated in comparison to primary pancreatic tumors. Patients and methods: Each 5 patients with pancreatic metastases of a renal cell carcinoma, a ductal carcinoma, a neuroendocrine tumor and a pancreati tis-associated mass were investigated by B-mode sonography, fundamental and echo-enhanced power-Doppler sonography. Results: Similar to neuroendocrine tumors, metastases of renal cell carcino mas were found to be hypervascularized. in contrast, ductal carcinomas are hypovascularized compared to the surrounding tissue. Tumors associated with pancreatitis show different vascularization pattern depending on inflammat ion and necrosis. Conclusions: Metastases of renal cell carcinomas and ductal carcinomas show different vascularization pattern at echo-enhanced power-Doppler sonograph y. Renal sonography and neuroendocrine tumors have similar contrast behavio rs, therefore, clinical symptoms should be referred for their differentiati on. However, histology is the standard of reference for the differential di agnosis of pancreatic tumors.