PMID: 18182746Jan 10, 2008Paper

Unusual magnetic resonance image of an insulinoma with extensive desmoplastic reaction

JOP : Journal of the Pancreas
Nagihan InanYesim Gurbuz

Abstract

Unlike other islet-cell tumors, insulinomas are usually benign. Most insulinomas have a high signal intensity on T2-weighted images and a low signal intensity on T1-weighted images, and are hyperintense on immediate post-gadolinium images. However, in rare cases, insulinomas may be hypointense on T2-weighted images and on immediate post-gadolinium images, mimicking a ductal adenocarcinoma. We present a case of a surgically proven insulinoma which was hypointense on both T2-weighted and immediate post-gadolinium T1-weighted images, but hyperintense on late phase T1-weighted images. Histopathological examination of the surgical specimen revealed a prominent desmoplastic reaction which accounted for the low signal on T2-weighted images and the contrast enhancement pattern. Delayed contrast enhancement reflects the desmoplastic component of this tumor. Insulinomas with an extensive desmoplastic reaction may appear hypointense on T2-weighted images with minimal enhancement on immediate post-gadolinium images. Late phase fat-suppressed T1-weighted post-gadolinium images may be useful in the detection of such tumors.

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Adenoma, Islet Cell

Islet Cell Adenoma arises in the islet cells, which are insulin producing cells of the pancreas. These tumors can be either malignant or benign. Discover the latest research on Islet Cell Adenoma here.

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