Osteoclast-like giant cell tumors of the pancreas and liver

Osteoclast-like giant cell tumors （OGCT） are rare abdominal tumors, which mainly occur in the pancreas. The neoplasms are composed of two distinct cell populations and frequently show an inhomogenous appearance with cystic structures. However, due to the rarity of these tumors, only very limited clinical data are available. Imaging features and sonographic appearance have hardly been characterized. Here we report on two cases of osteoclast-like giant cell tumors, one located within the pancreas, the other within the liver, in which OGCTs are extremely rare. Both patients were investigated by contrast sonography, which demonstrated a complex, partly cystic and strongly vascularized tumor within the head of the pancreas in the first patient and a large, hypervascularized neoplasm with calcifications within the liver in the second patient. The liver OGCT responded well to a combination of carboplatin, etoposide and paclitaxel. With a combination of surgical resection, radiofrequency ablation and chemotherapy, the patient＇s survival is currently more than 15 too, making him the longest survivor with an OGCT of the liver to date.

消化系神经内分泌肿瘤超声造影表现特征分析

目的分析消化系统神经内分泌瘤(NET)原发病灶及肝转移灶超声造影(CEUS)表现特征,评价CEUS诊断消化系NET的价值。方法 2005—2009年Charité医院收治90例经手术和(或)穿刺活检病理确诊的消化系NET患者。回顾性分析79个消化系NET原发病灶、510个肝转移灶常规超声表现及69个原发病灶、70个肝转移灶CEUS表现。结果常规超声示79个消化系NET原发病灶以低回声和混合回声为主,69.7%(23/33)的小肠NET原发病灶和64.3%(18/28)的胰腺NET原发病灶内部回声不均,27.8%(22/79)的消化系NET原发病灶含部分液化区。CEUS示69个消化系NET原发病灶中93.3%(63/69)血供丰富,72.5%(50/69)呈向心性增强。常规超声示510个肝转移灶中39.1%(199/510)表现为低回声,34.1%(174/510)为高回声,23.7%(121/510)为混合回声;32.7%(167/510)的肝转移灶周围存在声晕。CEUS示肝转移灶中70.0%(49/70)为向心性增强,27.1%(19/70)为快速整体增强,呈离心充盈的仅占2.9%(2/70);78.7%(55/70)的肝转移灶在60s内开始出现增强消退。结论消化系NET原发病灶及肝转移灶具有特征性CEUS表现。CEUS可作为NET影像诊断学方法之一。