Diminishing calcifications as a potential predictor of pancreatic ductal adenocarcinoma arising in association with IPMN in patients with chronic pancreatitis

Chronic pancreatitis (CP) is a progressive benign fibroinflammatory condition involving repeated episodes of pancreatic inflammation, which lead to fibrotic tissue replacement and subsequent pancreatic insufficiency. A lifetime risk of developing pancreatic ductal adenocarcinoma (PDAC) in patients w...

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Bibliographic Details
Published in:Radiology case reports 2024-11, Vol.19 (11), p.5299-5303
Main Authors: Yasrab, Mohammad, Rizk, Ryan C., Lopez-Ramirez, Felipe, Ahmed, Taha M., Blanco, Alejandra, Javed, Ammar A., Chu, Linda C., Fishman, Elliot K., Kawamoto, Satomi
Format: Article
Language:English
Subjects:
Chronic pancreatitis
Computed tomography
Diminishing calcification
Intraductal papillary mucinous neoplasm
Pancreatic ductal adenocarcinoma
Pancreatic neoplasms
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Summary:Chronic pancreatitis (CP) is a progressive benign fibroinflammatory condition involving repeated episodes of pancreatic inflammation, which lead to fibrotic tissue replacement and subsequent pancreatic insufficiency. A lifetime risk of developing pancreatic ductal adenocarcinoma (PDAC) in patients with chronic pancreatitis is reported to be 1.5%-4%. However, diagnosis of PDAC in patients with CP can be challenging, in part due to overlapping imaging features. In rare instances, pancreatic parenchymal calcifications that are typically associated with chronic pancreatitis may diminish in the case of a developing PDAC. In this article, we present a patient with chronic pancreatitis in whom calcifications decreased at the time of pancreatic ductal adenocarcinoma diagnosis, as compared to prior CT imaging. The unique imaging features of “diminishing calcifications” associated with a hypoattenuating lesion can potentially be a useful sign of pancreatic ductal adenocarcinoma and may aid in early diagnosis and prompt treatment intervention.
ISSN:1930-0433
1930-0433
DOI:10.1016/j.radcr.2024.08.018