Imaging findings of pancreatoblastoma in 4 children including a case of ectopic pancreatoblastoma

Abstract

Pancreatoblastoma is a rare primary pancreatic neoplasm of children. The tumour may arise from any portion of the pancreas, but no tumour originating from ectopic pancreatic tissue has been reported in the English medical literature. We report the radiological findings of pancreatoblastoma in four children, including one tumour originating from the mesentery, to our knowledge, reported for the first time. Four children with pancreatoblastoma were identified at our hospital between 2000 and 2007. US and CT were performed in all children, with MR performed in two. Various CT and MRI features were evaluated including size, organ of origin, definition and quality of tumour margins, heterogeneity and attenuation of the mass, calcification, presence of ascites, adenopathy, metastases, and signal intensity on MR images. Complete excision was performed in all children. The diagnosis of pancreatoblastoma was confirmed with histopathological results. Our cases displayed some typical and atypical features of pancreatoblastoma. The findings of our series suggest that the majority of these tumours are large, heterogeneous and of low to intermediate signal intensity on T1-W images and high signal intensity on T2-W images. Calcifications were common on CT. All of the tumours had heterogeneous enhancement on CT and MR images. Pancreatoblastoma is a rare primary tumour of the pancreas. When a large mass is identified in the pancreas in children that is heterogeneous in nature with internal calcifications, the diagnosis should be considered.