Korean J Radiol.  2013 Oct;14(5):781-785. 10.3348/kjr.2013.14.5.781.

Unusual Features in an Adult Pancreatic Hemangioma: CT and MRI Demonstration

• Lu ZH
• Wu M

• KMID: 1711433
• DOI: http://doi.org/10.3348/kjr.2013.14.5.781

Abstract

Hemangiomas in the pancreas are very rare and only a few cases in adulthood have been reported in the literature. We describe a case of pancreatic hemangiomas in an adult with unique imaging findings. A 23-year-old woman visited the hospital for an incidentally detected pancreatic mass. CT and MRI revealed a multilocular cyst with fluid-fluid levels and no obvious enhancement. The patient underwent surgery and the mass was confirmed as a pancreatic hemangioma. The radiological features and differential diagnosis of this rare lesion are discussed.

Keyword

Pancreas; Hemangioma; Computed tomography; Magnetic resonance imaging

MeSH Terms

Female
Hemangioma/*diagnosis
Humans
Magnetic Resonance Imaging
Pancreatic Neoplasms/*diagnosis
Tomography, X-Ray Computed
Young Adult

Figure

• 

  Fig. 1 Twenty three-year-old woman with pancreatic hemangioma. (A) Plain CT scan of abdomen shows heterogeneous, well-defined mass (arrowhead) at pancreatic head (arrow). Enhanced CT scan at arterial phase (B) and at portal vein phase (C) shows mass has no enhancement and is multilocular cyst with fluid-fluid levels (arrowhead). The pancreas (arrow) shows abvious enhancement. Superior fluid layer shows low attenuation of fluid and inferior fluid layer shows higher attenuation. Superior fluid layer shows hyper SI on T1WI (D) and T2WI with fat suppression (E). Inferior fluid layer is slightly hyper SI to pancreas on T1WI (D) and hypo SI relative to superior fluid layer on T2WI with fat suppression (E). Mass shows no enhancement after injection of contrast material (F). Hematoxylin-eosin staining (G, original magnification × 40) reveals multiple vascular spaces containing blood and septation by fibrous tissue. Hematoxylin-eosin staining (H, original magnification × 100) reveals multiple vascular spaces containing blood, lined by single layer of uniformly flattened cells.

Reference

1. Kobayashi H, Itoh T, Murata R, Tanabe M. Pancreatic cavernous hemangioma: CT, MRI, US, and angiography characteristics. Gastrointest Radiol. 1991; 16:307–310.

2. Chang WT, Lee KT, Yang SF. Cavernous hemangioma of the pancreas: report of a case. Pancreas. 2003; 26:310–312.

3. Mundinger GS, Gust S, Micchelli ST, Fishman EK, Hruban RH, Wolfgang CL. Adult pancreatic hemangioma: case report and literature review. Gastroenterol Res Pract. 2009; 2009:839730.

4. Jarboui S, Salem A, Gherib BS, Ben Moussa M, Rajhi H, Mnif N, et al. Hemangioma of the pancreas in a 60-year-old woman: a report of a new case. Gastroenterol Clin Biol. 2010; 34:569–571.

5. Lee J, Raman K, Sachithanandan S. Pancreatic hemangioma mimicking a malignant pancreatic cyst. Gastrointest Endosc. 2011; 73:174–176.

6. Weidenfeld J, Zakai BB, Faermann R, Barshack I, Aviel-Ronen S. Hemangioma of pancreas: a rare tumor of adulthood. Isr Med Assoc J. 2011; 13:512–514.

7. Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Probl Surg. 2000; 37:517–584.

8. Soyer P, Bluemke DA, Fishman EK, Rymer R. Fluid-fluid levels within focal hepatic lesions: imaging appearance and etiology. Abdom Imaging. 1998; 23:161–165.

9. Ehara S, Sone M, Tamakawa Y, Nishida J, Abe M, Hachiya J. Fluid-fluid levels in cavernous hemangioma of soft tissue. Skeletal Radiol. 1994; 23:107–109.

10. Buck JL, Hayes WS. From the Archives of the AFIP. Microcystic adenoma of the pancreas. Radiographics. 1990; 10:313–322.

11. Kim HC, Yang DM, Kim HJ, Lee DH, Ko YT, Lim JW. Computed tomography appearances of various complications associated with pancreatic pseudocysts. Acta Radiol. 2008; 49:727–734.

12. Cho HW, Choi JY, Kim MJ, Park MS, Lim JS, Chung YE, et al. Pancreatic tumors: emphasis on CT findings and pathologic classification. Korean J Radiol. 2011; 12:731–739.