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Pancreatic adenocarcinoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Abdominal pain and anemia.

Patient Data

Age: 85 years
Gender: Male
ct

A 38×22mm low enhancing mass is noted at pancreatic uncinate process that infiltrates adjacent duodenal wall and partially encases superior mesenteric vessels. Surrounding fat stranding is present and a few small regional lymphadenopathies are observed. Extra and central intrahepatic bile ducts are mildly dilated and distal of CBD involved by the mass. 
A few small hypodense lesions are seen at liver less than 10mm which shows no obvious enhancement on post contrast images, most consistent with cysts. 
Several non-enhanced simple cortical cysts are seen at both kidneys, with maximum diameters of 48mm. In addition, an 8mm stone is noted at upper calyx of right kidney. 
The prostate gland is enlarged.
Degenerative changes as osteophytosis are seen at the lumbar spine.

Case Discussion

Path proven pancreatic adenocarcinoma with local invasion, vascular encasement and small regional lymphadenopathies.

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