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Case Reports in Radiology
Volume 2014, Article ID 820359, 5 pages
http://dx.doi.org/10.1155/2014/820359
Case Report

Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report

1Sant’Andrea Hospital, Rome, Department of Radiology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, Italy
2Sant’Andrea Hospital, Rome, Department of Gastroenterology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Di Grottarossa, 1035-00135 Rome, Italy

Received 3 December 2013; Accepted 5 January 2014; Published 13 February 2014

Academic Editors: D. P. Link and S. Masala

Copyright © 2014 Elsa Iannicelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Context. One of the characteristic findings of intraductal papillary mucinous neoplasms (IPMN) is the presence of a direct communication between the lesion and the ductal pancreatic system and when magnetic resonance cholangiopancreatography (MRCP) shows uncertain findings, it is useful to perform a MRCP after secretin stimulation (MRCP-S) which provides a better visualization of the ductal system. Case Report. We present a case of 51-year-old man in whom, during a CT follow-up for a renal tumour, was found a cystic lesion of the pancreas. To better evaluate the lesion and its suspected communication with the pancreatic system, MR with gadolinium and MRCP and MRCP-S were performed. With the MRCP and MRI it was not possible to identify a clear communication between the cystic lesion and the ductal system. MRCP-S showed an increase in signal intensity of the lesion and its communication with the ductal system, allowing us to classify the cystic lesion as a main duct in intraductal papillary mucinous neoplasm. The patient underwent a surgical duodenal pancreatectomy. The histological result of the specimen confirmed the diagnosis of adenocarcinoma IPMN. Conclusion. In this case MRCP-S has allowed a clearer identification of the cystic lesion allowing a correct diagnosis and treatment.