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Daily Case Vignette - CTisus.com — Pancreas. Machine-transcribed; use the interactive transcript above to jump the player to any line.
The most likely diagnosis in the 60-year-old with an incidental masses, while I see a vascular lesion in the head of the pancreas, was washes out on the venous phase imaging. I have to admit, I don't think too much about this case before I say it's a neuroendocrine tumor. It could be metastatic renal cell, but the kidneys look okay here. It's surely not pancreatic adenocarcinoma, which are hypovascular lesions. But it also could be a psiracist adenoma. Why do I say that? Because there's a type of psiracist adenomas that are very, very vascular and look identical to neuroendocrine tumors. They wash out, and it's a real challenge. And this ended up being biopsyde and indeed was a solid psiracist adenoma. You can see the marked vascularity. I have to admit, there's no way you could say this wasn't a neuroendocrine tumor
and statistically probably is more likely a neuroendocrine tumor, but this was a psiracist adenoma. So I'm giving credit for A and B, but remember to think about psiracist adenomas. Again, EOS with biopsy, looking at fluid with a psiracist adenoma, VHL markers are positive.
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