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Pancreatoblastoma in an Adult Woman: Sonography, CT, and Dynamic Gadolinium-Enhanced MRI Features

Joshua L. Rosebrook1, Jonathan N. Glickman2 and Koenraad J. Mortele1

1 Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
2 Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.



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Fig. 1A. 29-year-old woman with pancreatoblastoma. Contrast-enhanced axial CT image shows a well-defined mass (white arrow) with cystic and enhancing solid components in the body of the pancreas.

 


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Fig. 1B. 29-year-old woman with pancreatoblastoma. Sonographic image of the pancreas body shows a well-defined, hypoechoic mass (white arrow) and hyperechoic rim demonstrating Doppler flow.

 


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Fig. 1C. 29-year-old woman with pancreatoblastoma. T2-weighted image shows pancreatic mass with a 3-mm-thick low signal rim (black arrow) and high signal center (white arrow), indicating a cystic component.

 


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Fig. 1D. 29-year-old woman with pancreatoblastoma. Unenhanced fat saturated T1-weighted image shows pancreatic mass with intermediate signal rim (black arrow) and low to intermediate signal intensity centrally (white arrow).

 


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Fig. 1E. 29-year-old woman with pancreatoblastoma. Dynamic contrast-enhanced fat saturated T1-weighted images in arterial (E), portal (F), and equilibrium phases (G) show early and persistent enhancement within rim of pancreatic mass. Central portion of mass does not enhance.

 


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Fig. 1F. 29-year-old woman with pancreatoblastoma. Dynamic contrast-enhanced fat saturated T1-weighted images in arterial (E), portal (F), and equilibrium phases (G) show early and persistent enhancement within rim of pancreatic mass. Central portion of mass does not enhance.

 


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Fig. 1G. 29-year-old woman with pancreatoblastoma. Dynamic contrast-enhanced fat saturated T1-weighted images in arterial (E), portal (F), and equilibrium phases (G) show early and persistent enhancement within rim of pancreatic mass. Central portion of mass does not enhance.

 


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Fig. 1H. 29-year-old woman with pancreatoblastoma. Time-intensity curves of the enhancement pattern show the rim of the mass and demonstrate early and persistent enhancement more than normal pancreatic parenchyma, with little enhancement centrally.

 


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Fig. 1I. 29-year-old woman with pancreatoblastoma. Gross photograph of tumor shows a well-circumscribed solid mass (arrow) with central necrosis.

 


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Fig. 1J. 29-year-old woman with pancreatoblastoma. Photomicrograph of viable portion of tumor shows tumor cells arranged in nests and trabeculae with focal glandular features (arrow). (H and E, x 100)

 

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