Metastasis-Induced Acute Pancreatitis Successfully Treated with Chemotherapy and Radiotherapy in a Patient with Small Cell Lung Cancer.

Although involvement of pancreas is a common finding in small cell lung cancer (SCLC), metastasis-induced acute pancreatitis (MIAP) is very rare. A 50-year-old female with SCLC who had limited disease and achieved full response after treatment presented with acute pancreatitis during her follow-up. The radiologic studies revealed a small area causing obliteration of the pancreatic duct without mass in the pancreatic neck, and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) confirmed the metastasis of SCLC. The patient was treated successfully with systemic chemotherapy and radiotherapy delivered to pancreatic field. In SCLC, cases of MIAP can be encountered with conventional computed tomography with no mass image, and positron emission tomography and EUS-FNA can be useful for diagnosis of such cases. Aggressive systemic and local treatment can prolong survival, especially in patients with good performance status.

Groove (paraduodenal) pancreatitis: Report of two cases.

"Groove" pancreatitis is a rare segmental form of chronic pancreatitis that involves the area located between the common bile duct, head of the pancreas and duodenum. It is more common in middle-aged males who have a history of alcohol abuse. The differential diagnosis varies from anatomic variants to malignancies. The most relevant differential diagnosis of groove pancreatitis is adenocarcinoma of the head of the pancreas. Most of the cases were diagnosed after pancreatic resection. Thus, the correct diagnosis of this rarely seen disease is very important to avoid unnecessary tests or procedures and to determine the definitive treatment.

Imaging findings after fascial injection of tetanus vaccine.

Adverse reactions to vaccines vary from mild to fatal. Local reactions are often due to hypersensitivity to the adjuvant substances in the vaccine. This case report aims at illustrating the imaging findings of a fascial injection of the tetanus vaccine. A 14 year-old boy, vaccinated 6 months previously presented with a mass lesion in the left deltoid area. Magnetic resonance imaging and ultrasonographic evaluations were performed and the findings were characteristic for fascial granuloma. The histopathologic examination confirmed the diagnosis. In our knowledge, this is the first case of granuloma post intrafascial injection of tetanus vaccine which was MRI and ultrasonographic evaluated and histopathologicly confirmed.