70 year old female presented with abdominal pain and vomiting
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There is a large ill-defined hypodense lesion in the body of the pancreas, casusing distal pancreatic atrophy and through which both splenic artery and vein are passing (invaded by the lesion). The SMA and celiac trunk appear to have retained their fat planes.
The liver is heterogenous, atrophic and has nodular surface, with relative caudate hypertrophy. Does the patient have a known history of cirrhosis? The liver contains few hypoattenuating lesions, in keeping with mets. No arterial enhancing focal hepatic lesions.
The stomach is distended, raising the possibility of the pylorus involvement by the lesion (no clear fat planes can be seen between the lesion and the distal stomach).
No intra or extra axial biliary dilatation.
Path proven adenocarcinoma of the pancreas.