Presentation
Abdominal pain and palpable mass on physical exam.
Patient Data
A 117× 74 mm large low-enhancing mass with irregular margins is noted in the pancreatic body and tail that shows internal necrotic changes. The mass partially encases the splenic artery and vein. The fat plane between the mass and adjacent spleen is preserved.
Multiple varying-sized enlarged lymph nodes are seen in the mesenteric and para-aortocaval regions with SAD less than 38 mm.
In addition, the left adrenal gland is enlarged and infiltrated by the mass.
Multiple low-enhancing masses in the liver less than 23mm infer metastases.
Several nodules, mostly subpleural in both lungs, less than 14 mm, suggest metastases.
The prostate gland is enlarged.
Case Discussion
Large pancreatic mass; pathology-proven ductal adenocarcinoma with partial vascular encasement, mesenteric and para-aortocaval lymphadenopathy, and lung, liver and left adrenal metastasis.
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