Pancreatic cancer liver metastasis mimicking focal nodular hyperplasia. A case report.

Oliver Wedel Fischer, Tobias Freyberg Justesen, Christian Pallson Nolsøe, Christo Pentchev Pentchev, Evelina Georgieva Atanasova
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Abstract

Metastases to the liver from gastroenteropancreatic neuroendocrine tumors are varied in their presentation and echogenicity on ultrasound. We present a case of adenocarcinoma of the pancreas with sporadic neuroendocrine differentiation and metastasis to the liver, referred for inclusion in a clinical study. Standard ultrasound showed two hypoechoic focal liver lesions. On contrast enhanced ultrasound (CEUS) the larger tumour bore an enhancement resemblance to that of a focal nodular hyperplasia (FNH). This result necessitated a histological confirmation, which indicated neuroendocrine, highly differentiated tumour tissue, compatible with metastasis from the patient's pancreatic cancer. This case showcases the role of histologically confirmed diagnosis in liver lesions with atypical imaging characteristics, especially in patients with a history of malignancy and potential oncological treatment.

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模仿局灶性结节增生的胰腺癌肝转移。病例报告。
胃肠胰神经内分泌肿瘤转移到肝脏的表现和超声回声各不相同。我们介绍了一例胰腺腺癌伴有散发性神经内分泌分化并转移至肝脏的病例,该病例被转介到临床研究中。标准超声显示肝脏有两个低回声病灶。对比增强超声(CEUS)显示,较大的肿瘤增强后与局灶性结节增生(FNH)相似。这一结果需要进行组织学确认,结果显示为神经内分泌、高分化肿瘤组织,与患者的胰腺癌转移相符。该病例展示了组织学确诊在具有非典型影像学特征的肝脏病变中的作用,尤其是在有恶性肿瘤病史和可能接受肿瘤治疗的患者中。
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