Pancreatic neoplasms are rare in children and young adults, with an incidence of 0.46 per million under 30 years of age. Fortunately, children with a pancreatic neoplasm have a better prognosis than adults. The better prognosis and rarity of disease both contribute to the fact that pancreatic malignancies account for less than 0.2% of cancer-related deaths. Ultrasound is often the initial imaging modality to identify a pancreatic neoplasm due to its use for evaluation of symptoms such as upper abdominal pain, a palpable epigastric mass, or jaundice. Known pancreatic masses, or those detected initially by ultrasound should be imaged with CT or MRI to best characterize the mass and its relationship to adjacent structures, particularly the vasculature. Nuclear medicine plays a role in imaging of some pancreatic neoplasms depending on histology. Once a pancreatic neoplasm is identified, the radiologist is tasked with making a diagnosis from a differential diagnosis list of rare tumors. Primary pancreatic neoplasms are divided into epithelial and nonepithelial types. The epithelial tumors are more common and may be further subdivided into exocrine or endocrine subtypes. Epithelial exocrine tumors are the most common in children. Examples of these tumors include the two most common pediatric pancreatic neoplasms pancreatoblastoma and solid-pseudopapillary neoplasms. Endocrine tumors are uncommon. While functioning endocrine tumors can occur, non-functioning tumors are more common and are associated with syndromes such as von Hippel Lindau, multiple endocrine neoplasia type 1, and tuberous sclerosis. Nonepithelial tumors are also rare and include a number of different entities such as lymphoma, neurofibroma, and teratomas. Finally, the pancreas is an extremely rare site of metastasis. Pancreatic metastases can occur with multiple primary malignancies including neuroblastoma, rhabdomyosarcoma, and osteosarcoma. This exhibit will describe the imaging work-up of pancreatic tumors in children. We will illustrate the different clinical manifestations and imaging appearances of the various pediatric pancreatic neoplasms. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Hasweh Reem, Trout Andrew, Towbin Alexander

Keywords: pancreas