Diminishing calcifications as a potential predictor of pancreatic ductal adenocarcinoma arising in association with IPMN in patients with chronic pancreatitis

Mohammad Yasrab, MD; Ryan C. Rizk, MS; Felipe Lopez-Ramirez, MD; Taha M. Ahmed, MD; Alejandra Blanco, MD; Ammar A. Javed, MD; Linda C. Chu, MD; Elliot K. Fishman, MD; Satomi Kawamoto, MD

Radiology Case Reports (Nov 2024)

Diminishing calcifications as a potential predictor of pancreatic ductal adenocarcinoma arising in association with IPMN in patients with chronic pancreatitis

Mohammad Yasrab, MD,
Ryan C. Rizk, MS,
Felipe Lopez-Ramirez, MD,
Taha M. Ahmed, MD,
Alejandra Blanco, MD,
Ammar A. Javed, MD,
Linda C. Chu, MD,
Elliot K. Fishman, MD,
Satomi Kawamoto, MD

Affiliations

Mohammad Yasrab, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author.
Ryan C. Rizk, MS: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Felipe Lopez-Ramirez, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Taha M. Ahmed, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Alejandra Blanco, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Ammar A. Javed, MD: Department of Surgery, New York University Langone Hospital, New York, NY, USA
Linda C. Chu, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Elliot K. Fishman, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Satomi Kawamoto, MD: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Journal volume & issue: Vol. 19, no. 11
pp. 5299 – 5303

Abstract

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Chronic pancreatitis (CP) is a progressive benign fibroinflammatory condition involving repeated episodes of pancreatic inflammation, which lead to fibrotic tissue replacement and subsequent pancreatic insufficiency. A lifetime risk of developing pancreatic ductal adenocarcinoma (PDAC) in patients with chronic pancreatitis is reported to be 1.5%-4%. However, diagnosis of PDAC in patients with CP can be challenging, in part due to overlapping imaging features. In rare instances, pancreatic parenchymal calcifications that are typically associated with chronic pancreatitis may diminish in the case of a developing PDAC. In this article, we present a patient with chronic pancreatitis in whom calcifications decreased at the time of pancreatic ductal adenocarcinoma diagnosis, as compared to prior CT imaging. The unique imaging features of “diminishing calcifications” associated with a hypoattenuating lesion can potentially be a useful sign of pancreatic ductal adenocarcinoma and may aid in early diagnosis and prompt treatment intervention.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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