Pancreatic adenocarcinoma - staging teaching case with extensive vascular encasement
Ill-defined infiltrative pancreas head mass is difficult to confidently measure and distinguish from the peripancreatic infiltrative disease. Encasement and severe focal narrowing of the portal vein. Encasement of upper abdominal arteries including the celiac axis with infiltration of the celiac plexus, narrowing of the common hepatic artery with note of post stenotic dilation of the proper hepatic artery, encasement of the superior mesenteric artery. Mildly enlarged peripancreatic lymph nodes mildly dilated gallbladder and common bile duct with some biliary enhancement related to stenting/inflammation. Some areas of low-attenuation along the inferior right liver edge near segment 5/6 border are probably related to geographic fat. Fat-containing left spiculated hernia. Abdominal aortic aneurysm.
Case Discussion
Teaching staging case highlighting advanced presentation of locally advanced disease with vascular invasion involving upper abdominal arteries and veins with vascular narrowing. Note how the primary tumor is difficult to confidently measure, however with such characteristic vascular involvement, the diagnosis of pancreas cancer can be made confidently in this case. In particular, note how there is severe narrowing of the portal vein and also mild narrowing and irregularity of the common hepatic artery with poststenotic dilation of the proper hepatic artery. Also noted borderline/suspicious peripancreatic lymph nodes. This is unfortunately unresectable disease.
Unable to process the form. Check for errors and try again.