Metastatic pancreatic cancer

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Abdominal pain and elevated liver enzymes.

Patient Data

Age: 75 years
Gender: Female

32 x 28 mm ill-defined hypoenhancing mass at pancreatic tail accompanied by surrounding fat stranding. Fat plane between the mass and adjacent spleen is obliterated. 

Multiple hypodense hypoenhancing masses in both liver lobes, the largest measuring less than 45 mm in length. The CBD is dilated up to 13 mm in diameter.

Degenerative changes as osteophytosis are seen at the lumbar spine.
Scoliosis with leftward convexity is present at lumbar spine.
Grade I spondylolisthesis of L3 on L4 is present.

Case Discussion

Pathology proven pancreatic adenocarcinoma with suspected local invasion and multiple hepatic metastases.

CT is the workhorse of pancreatic imaging. Typically ductal adenocarcinomas appear as poorly defined low enhancing masses with extensive surrounding desmoplastic reaction.

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