A case of neck pain
65 yo F with neck pain for a few months. CT shows pathological fracture of C7 and T1, confirmed on MRI. A search for the primary ensued.
Conventional CT of the abdomen shows mild pancreatic ductal dilatation in the tail of the pancreas but is otherwise unremarkable. MRI shows a hypo enhancing mass in the pancreatic tail with restricted diffusion. Small (1.5 cm) pancreatic adenocarcinoma confirmed with endoscopic ultrasound and biopsy.
Review of 40 keV spectral images shows clear hypo-enhancing mass in pancreatic tail, corresponding excellently with mass seen on MRI. Spectral CT can be a life-saver in this situation.