Presentation
Abdominal pain and progressive distention.
Patient Data
Moderate to severe abdominopelvic ascites is present, accompanied by omental thickening and several small peritoneal soft tissue density masses inferring tumoral deposits.
A 48×35 mm ill-defined low-enhancing mass is noted at the pancreatic tail. The mass invades the adjacent gastric wall and partially encases splenic vessels.
Several small ill-defined low-enhancing masses are seen at the liver less than 27 mm most consistent with metastases. Additionally, several thin-walled non-enhanced cysts are present at the liver less than 40 mm.
A 14 mm stone is noted in the gallbladder.
A 45 mm partially exophytic cystic lesion with thick marginal calcification is seen at the left kidney. Additionally, a few non-enhanced simple cortical cysts are noted at both kidneys, with maximum diameter of 28 mm.
In imaged portions of lower thorax; subtle pleural effusion is present bilaterally.
Post-operative changes are seen at posterior arch of lower lumbar spine.
Case Discussion
Pancreatic tail mass; pathology proved ductal adenocarcinoma, with local invasion, vascular encasement, hepatic metastasis, ascites and peritoneal seeding.