case_images: PMC7648702_01
case_images: Contrast-enhanced CT images in the arterial (a) phase and delayed (b) phase. CT shows a sausage-shape enlargement of the pancreas (arrows), with relatively homogenously remarkable enhancement in the arterial phase and washout in the delayed phase with the capsule-like rim at the surface (arrowheads). The pancreatic duct did not dilate.
case_images: CRIONM2020-8815745.001.jpg
case_images: PMC7648702_01_CRIONM2020-8815745.001.jpg
case_images: fig1
case_images: CT scan confirmed enlargement of the pancreas with relatively homogenous enhancement remarkably in the arterial phase and washout in the delayed phase (Figure 1).
case_images: CT images before (a) and in the late arterial (b), portal venous (c), and delayed (d) phases after contrast administration. The metastases hyper enhance dramatically in the arterial phase and subsequently fade toward mild hypoattenuation relative to the liver in the delayed phase (arrows). Some portions of the lesions do not enhance, suggesting necrosis. Many similar lesions are scattered throughout the liver parenchyma (not shown).
case_images: CRIONM2020-8815745.002.jpg
case_images: PMC7648702_01_CRIONM2020-8815745.002.jpg
case_images: fig2
case_images: Multiple liver lesions showed early arterial enhancement with washout in the delayed phase suggesting hypervascular metastases (Figure 2).
case_images: MRI on T1-weighted image (a), T2-weighted image (b), and arterial phase (c) and delayed phase (d) in T1-weighted image with fat-sat after contrast administration. MRI shows a diffusely enlarged pancreas with low intensity on T1-weighted imaging and heterogeneous high intensity on T2-weighted imaging, particularly in the body and tail region of the pancreas. The pancreas also shows remarkable enhancement in the arterial phase and washout in the delayed phase.
case_images: CRIONM2020-8815745.003.jpg
case_images: PMC7648702_01_CRIONM2020-8815745.003.jpg
case_images: fig3
case_images: The patient subsequently underwent MRI that showed characteristics similar to ultrasound and CT with a diffusely enlarged pancreas with low signal intensity on T1-weighted, high signal intensity heterogeneous on T2-weighted, restricted diffusion on diffusion-weighted imaging, and relatively homogenous enhancement on postcontrast T1-weighted images (Figure 3).