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Pancreatic head melanoma producing obstructive jaundice: magnetic resonance characteristics aiding differentiation
G Solomons1, R N Gibson, R J Tello
1Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia. docgws@ozemail.com.au
Abstract:
A case is reported of malignant melanoma presenting as a mass in the head of the pancreas producing obstructive jaundice. On MR imaging the mass displayed signal characteristics not typical of adenocarcinoma but instead exhibited a low signal on T2-weighted images and early phase dynamic enhancement, the combination of which should suggest the possibility of melanoma.
Insights
Malignant melanoma can rarely present as a pancreatic head mass causing jaundice. Specific magnetic resonance imaging (MRI) findings, including low T2 signal and early enhancement, can suggest melanoma over adenocarcinoma.
Area of Science:
- Oncology
- Radiology
- Gastroenterology
Background:
- Pancreatic head masses typically raise suspicion for adenocarcinoma.
- Obstructive jaundice is a common presentation of pancreatic head malignancy.
Observation:
- A case of malignant melanoma presenting as a pancreatic head mass is described.
- The mass led to obstructive jaundice.
Findings:
- Magnetic resonance imaging (MRI) revealed atypical signal characteristics for adenocarcinoma.
- The mass showed a low signal on T2-weighted images.
- Early phase dynamic enhancement was observed on MRI.
Implications:
- The combination of low T2 signal and early dynamic enhancement on MRI should prompt consideration of pancreatic melanoma.
- This case highlights the importance of considering rare differentials in pancreatic imaging.
- Accurate diagnosis is crucial for appropriate patient management and treatment planning.
