A case of pancreatic hamartoma with characteristic radiological findings: radiological-pathological correlation
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A case of pancreatic hamartoma with characteristic radiological findings: radiological‑pathological correlation Kenji Toyama1 · Yohji Matsusaka1 · Shigeo Okuda1 · Eisuke Miura2 · Naoto Kubota2 · Yohei Masugi2 · Minoru Kitago3 · Shutaro Hori3 · Takahiro Yokose3 · Masahiro Shinoda3 · Michiie Sakamoto2 · Masahiro Jinzaki1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Pancreatic hamartoma is a rare benign tumor. Its preoperative diagnosis is challenging. We present a case of pancreatic hamartoma whose radiological-pathological correlation was evaluated in detail. A 53-year-old man was referred to our institution for diagnosis and treatment. Contrast-enhanced computed tomography (CT) and magnetic resonance image revealed a 3.5 cm long tumor arising from the head of the pancreas with cystic and solid components, the latter of which was gradually and inhomogeneously enhanced in the delayed phase. Fluorodeoxyglucose (FDG) positron emission tomography/CT revealed slight FDG uptake in the solid component. Histologically, a number of pancreatic lobule-like structures, which were mainly composed of aggregates of small ducts embedded in concentric fibrous stroma with no apparent islets or peripheral nerves, were observed in the solid component, whereas multiple dilated ducts were seen in the cystic region. The solid component also contained a narrow area of edematous fibrous stroma with low vessel density, which corresponded with the unenhanced part in the inhomogeneously enhanced solid component. There was no remarkable cytological atypia throughout the mass. A pathological diagnosis of pancreatic hamartoma was made. The radiological findings agree well with the pathological findings. When a pancreatic tumor is of the solid type, preoperatively diagnosing it as pancreatic hamartoma is not possible. However, when a pancreatic tumor with cystic and solid components is inhomogeneously enhanced in contrast-enhanced studies, a diagnosis of pancreatic hamartoma can be considered. Keywords Pancreas · Hamartoma · Diagnosis · Computed tomography · Magnetic resonance imaging · Positron emission tomography
Introduction Pancreatic hamartoma is a rare benign tumor. Preoperatively diagnosing pancreas hamartoma is challenging [1], because it does not have definitive radiological finding and the sample used in fine needle aspiration (FNA) is too small for obtaining a pathological diagnosis of pancreatic hamartoma. Recently, the number of radiological and pathological * Yohji Matsusaka [email protected] 1
Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku‑ku, Tokyo 160‑8582, Japan
2
Department of Pathology, Keio University School of Medicine, Tokyo, Japan
3
Department of Surgery, Keio University School of Medicine, Tokyo, Japan
reports on pancreatic hamartoma has increased [2–6], and the radiological findings of pancreatic hamartoma have been elucidated. However, there are few reports that demonstrat
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