Pancreatic adenocarcinoma - body/tail with extensive local invasion
Presentation
Abdominal discomfort.
Patient Data
Large infiltrative mass of the pancreas body and tail, with upstream dilation of the pancreas tail but also some thickening and relative hypoenhancement of the remaining parenchyma suggesting tumor infiltration versus inflammation of the tail of well. Encasement of upper abdominal arteries with multifocal narrowing, with separate origins of the common hepatic and splenic arteries. Infiltration into the celiac plexus. Broad contact with the lesser gastric curvature, possible invasion. Enlarged gastrohepatic ligament lymph nodes. Mild thickening of the left adrenal gland, nonspecific. No occlusion of the splenic vein. Several liver lesions have characteristics of hemangiomata, with a few smaller subcentimeter hypoenhancing lesions are indeterminant. No biliary obstruction. No peritoneal disease.
Case Discussion
This case illustrates advanced presentation of pancreas body adenocarcinoma with extensive upper abdominal vascular and lymphatic infiltration with arterial narrowing. Tumors of the pancreas body and tail comparison later due to not obstructing the common bile duct and thus the patient does not present earlier with jaundice as with a typical pancreas head mass.