Presentation
A pancreatic mass was discovered on an ultrasound exam in a child on follow-up for nephroblastoma operated on 1 and 1/2 years prior (nephrectomy and chemotherapy).
Patient Data
Small relatively well-defined bilobulated mass of the pancreatic tail, isointense to the splenic tissue on T2, T2 fat sat, and FIESTA, and hypointense on T1 with restricted diffusion and moderate progressive heterogeneous enhancement that does not follow the normal splenic enhancement, excluding the possibility of intrapancreatic accessory spleen.
Digestive structures in the left renal bed (history of left nephrectomy).
Case Discussion
MRI features a bilobulated mass of the pancreatic tail in a child with a history of left nephrectomy with chemotherapy for nephroblastoma. This mass is atypical for intrapancreatic accessory spleen (with a potential differential including a pancreatic metastatic lesion).
An ultrasound-guided biopsy of the pancreatic mass was performed with a histopathological exam that confirmed the diagnosis of primary pancreatic neuroblastoma.
Neuroblastomas are the most common extracranial solid childhood malignancy and the third most common childhood tumor after leukemia and brain malignancies. Around 30–35% of neuroblastomas are of extra-adrenal location in the retroperitoneum 1.
Primary pancreatic neuroblastoma is rare in children, and only very few cases have been reported in the literature 1,2.
Additional contributor: ZE. Boudiaf, MD, CIM Aurès, Batna, Batna
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