Functioning acinar cell pancreatic carcinoma: diagnosis on mangafodipir trisodium (Mn-DPDP)-enhanced MRI

We describe the imaging findings of a functional pancreatic acinar cell carcinoma in a patient who presented with weight loss, hyperlipasemia, and multiple foci of subcutaneous fat necrosis. The tumor invaded the adjacent splenic and portal vein, causing isolated left-sided portal hypertension. At MRI, the tumor showed marked enhancement following administration of the hepatobiliary-specific contrast agent mangafodipir trisodium (Mn-DPDP), thereby demonstrating the functional nature of the tumor. Avid uptake of Mn-DPDP by a functioning pancreatic tumor has not been reported in the radiology literature.