Chronic pancreatitis is a known risk factor for pancreatic carcinoma. After 20 years of chronic pancreatitis, there is a 6% cumulative risk of developing pancreatic adenocarcinoma.

DD of this lesion is the inflammatory mass known as mass-forming chronic pancreatitis. However, tumor markers were done for this patient and results were favoring the neoplastic possibility:

• very high CA 19-9 measures 490.9 U/mL (Normal is up to 36 U/mL)
• high carcinoembryonic antigen measures 5.04 ng/mL (normal is up to 3.8 ng/mL)

The patient was prepared for Whipple operation.

Contributions by Dr. Mohamed Mahmoud Elthokapy