There is a mass in the uncinate process of the pancreas centred inferior, posterior, and medial to the ampulla. As a result, there is only mild prominence of the main pancreatic duct. There is a somewhat elongated low density structure within the tumour, which either represents a focally dilated side branch ducts or else central necrotic/cystic change. There is intra-hepatic duct dilatation and the common bile duct measures 9 mm in diameter. Complete loss of fat planes between the tumour and segment deep three of the duodenum.
Normal variant anatomy with the left and right hepatic artery arising off the coeliac axis. Coeliac axis, hepatic arteries, superior mesenteric artery are clear of tumour.
The portal vein is clear of tumour. There is a short segment contact of abnormal soft tissue at the level of the tumour with a left tributary to the superior mesenteric vein. The main superior mesenteric vein is clear of tumour.
There are no abnormal lymph nodes by size or appearance in the chest, abdomen or pelvis.
Several subcentimetre low density liver lesions are seen, best appreciated on coronal portal venous phase portal venous phase. These are indeterminate but should be regarded with suspicion for metastasis.
A number of simple renal cysts are noted, otherwise the kidneys are normal. The adrenal glands and spleen are normal. No concerning bone lesion.