Presentation
Abdominopelvic pain and jaundice.
Patient Data
A 46 × 32 mm ill-defined low enhancing mass is present at the pancreatic head and uncinate process that infiltrates the adjacent duodenal wall and abuts the SMA and SMV. Peripancreatic fat stranding is seen. The pancreatic duct is mildly dilated.
Additionally, several enlarged lymph nodes are noted at porta hepatis and peripancreatic regions with SAD less than 15 mm.
The gallbladder is not seen at the anatomical location due to prior resection. A percutaneous drain catheter is inserted in central bile ducts.
Mild hydronephrosis without hydroureter is present on the left side. A 13 mm stone (1086HU) is seen at the left renal collecting system. Two 4 mm and 2 mm stones are also observed at the lower calyces of the right kidney.
In imaged portions of the lower thorax, multiple varying-sized nodular lesions are seen at both lung bases inferring metastases. A small amount of pleural effusion on the right side and hyperinflated emphysematous left lower lung lobe with bronchiectasis changes are also noted.
The prostate gland is enlarged.
Case Discussion
Locally advanced metastatic pancreatic mass; pathology proved pancreatic ductal adenocarcinoma.
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