Presentation
Abdominal pain and elevated liver enzymes.
Patient Data
A 40×28 mm low-enhancing mass at the pancreatic head and neck causes distal pancreatic parenchymal atrophy and duct dilatation. The mass partially encases the adjacent splenic vein.
A few enlarged lymph nodes with SAD less than 28 mm are seen in the vicinity of the mass. Some of them show internal necrotic changes.
Multiple varying-sized low-enhancing masses are observed throughout the liver less than 65 mm.
In addition, small volume of abdominopelvic free fluid is evident.
An 80 mm cyst with internal septations at the lower pole of the right kidney contains linear calcification in some of the septations. In addition, several simple cysts are pointed out in kidneys less than 60 mm.
In imaged portions of the lower thorax, subtle pleural effusion is noted bilaterally. A 10 mm calcified subpleural nodule is also observed at the right lung base.
The prostate gland is enlarged.
Case Discussion
Pathology-proven pancreatic ductal adenocarcinoma with a vascular encasement, regional lymphadenopathy, hepatic metastases and mild ascites.
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