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Pancreatic adenocarcinoma

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

Abdominal pain and vomiting.

Patient Data

Age: 70 years
Gender: Female
ct

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. 

Case Discussion

Pathologically proven adenocarcinoma of the pancreas.

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