MALİGN PANKREAS TÜMÖRÜNE BAĞLI SİNİSTRAL PORTAL HİPERTANSİYON TANISINDA FDG PET/BT’NİN ROLÜ: OLGU SUNUMU

Abstract

Tanı amacı ile [18F]-2-floro-2-deoksi-D-glukoz (FDG) Pozitron emisyon tomografisi (PET)/bilgisayarlı tomografi (BT) görüntüleme yapılan 67 yaşındaki erkek olguda pankreas kuyruk kesiminde 40x32x26 mm boyutlarda, düzensiz konturlu, yoğun FDG tutulumu gösteren (SUV maks: 6.14) primer solid malign pankreas tümörü saptandı. Splenik ven proksimalinin sınırları kitleden ayrılamadı. Dalak hilusunda çok sayıda splenoportal (gastrosplenik) kollateral venöz yapılar saptanmış olup bulgular pankreastaki malign tümörün splenik ven invazyonuna/basısına bağlı gelişmiş sinistral portal hipertansiyon (SPH) ile uyumlu bulundu. FDG PET/BT, malign pankreas tümörüne ikincil SPH’nin tanısında ve eşlik eden bulguların gösterilmesinde yararlı bulunmuştur.

Keywords

• Fluorodeoksiglukoz F18,pozitron-emisyon tomografi/bilgisayarlı tomografi,Pankreas,Abdominal neoplaziler,Hipertansiyon,Portal

References

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2. Sakorafas GH, Sarr MG, Farley DR, Farnell MB. (2000). The significance of sinistral portal hypertension complicating chronic pancreatitis. Am J Surg; 179(2):129–33.
3. Coşar Ayaz S , Durmaz HA , Döğen ME. (2019). Mide adenokarsinomlarında primer tümör ve karaciğer metastazlarının FDG PET/BT parametrelerinin karşılaştırılması. Cumhuriyet Üniv Sağ Bil Enst Derg 2019; 4(2):28-5.
4. Lim JS, Yun MJ, Kim MJ, Hyung WJ, Park MS, Choi JY, Kim TS, Lee JD, Noh SH, Kim KW. (2006): CT and PET in stomach cancer: preoperative staging and monitoring of response to therapy. Radiographics; 26(1):14–56.
5. M S Madsen, T H Petersen, and H Sommer. (1986). Segmental portal hypertension. Ann Surg; 204(1):72–7.
6. Wani NA, Lone TK, Shah AI, Khan AQ, Malik RA. (2011). Malignant solid pseudopapillary tumor of pancreas causing sinistral portal hypertension. Indian J Pathol Microbiol; 54(1):152–5.
7. Singhal D, Kakodkar R, Soin AS, Gupta S, Nundy S. (2006). Sinistral portal hypertension. A case report. JOP; 7(6):670–3.
8. Reddy A, Sanniyasi S, George DJ, Narayanan CD. (2016). A rare case report of solid pseudopapillary tumor of the pancreas with portal hypertension. Int J Surg Case Rep; 22:35−8.

9. Hakim S, Bortman J, Orosey M, Cappell MS. (2017). Case report and systematic literature review of a novel etiology of sinistral portal hypertension presenting with UGI bleeding: Left gastric artery pseudoaneurysm compressing the splenic vein treated by embolization of the pseudoaneurysm. Medicine (Baltimore); 96(13):e6413.
10. Chang CY. (1999). Pancreatic adenocarcinoma presenting as sinistral portal hypertension: an unusual presentation of pancreatic cancer. Yale J Biol Med; 72(4):295–300.