Endosonography with contrast medium for visualization and differential diagnosis of a pancreatic mass

This is the case of a 46-year-old patient in whom a 1 cm large intrapancreatic mass had incidentally been diagnosed by sonography 8 years previously. Since the patient had no clinical particulars, it was decided that a wait-and-see procedure with sonographic follow-up should be applied.
Here, the endosonographic visualization and characterization of the foci is shown and the differential diagnosis is discussed.

Take home messages:

Pancreatic neuroendocrine tumors are homogeneous, well vascularized and smoothly demarcated tumors.

The pancreatic duct proximal to the lesions is usually not dilated. A wait-and-see procedure with a sonographic follow-up examination is justified in tumors < 2 cm with typical characteristics.