The case demonstrates PE as a consequence of bilateral DVT, which itself was likely a paraneoplastic sequela of the advanced pancreatic cancer. The patient was admitted for therapy after the exam.
Incidental, clinically unsuspected PE can be sporadically encountered in oncological patients, especially in those with late-stage cancer 1. What makes them perilous is that staging and restaging exams are mostly done in an outpatient setting, where they are rarely read immediately. Many of these incidental pulmonary embolisms can be picked by the CT technicians who then can alert the radiologist, however, even this practice offers little protection against the delay in the diagnosis of more subtle "edge of the scan field" incidental PEs detected in abdominal exams, such as this.