Pancreatic carcinoma

Case contributed by Dr J. Ray Ballinger


Epigastric discomfort, anorexia and 20-pound weight loss over the preceding 2 months.

Patient Data

Age: 70 years
Gender: Male

The first image is a prone view from UGI series showing mass effect on 2nd and 3rd portions of the duodenal sweep.

The second image is an RAO view from UGI series showing mass effect on 3rd portions of the duodenal sweep with mild dilatation of proximal duodenum.


A subtle mass effect is seen on the 2nd and 3rd portions of the duodenum on the upper GI series. On CT, a 6 cm mass is seen arising from the uncinate process of the pancreas. CT shows encasement and compression of the SMA and SMV. Because of its position below the common bile duct, it was not obstructing the duct (documented on ultrasound) so there was no jaundice and minimal changes in liver enzymes. The pancreas and therefore this mass were obscured on ultrasound because of overlying bowel gas.


Case Discussion

Pancreatic cancer is the 4th leading cause of death in the United States increasing with age over 40 years. About 1/3 of cases are related to smoking. Most are of unknown cause though a very small number have a hereditary basis.

At the time of diagnosis, only about 20% of pancreatic carcinomas can be removed by surgery and in these cases cure rates are under 50%. In non-resectable cases, median survival is less than one year.

Differential diagnosis

  • lymphoma
  • focal pancreatitis
  • metastasis
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Case information

rID: 23672
Published: 2nd Jul 2013
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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