This case brings a bulky pancreatic head/uncinate process mass that extends into the hepatic hilum and is associated with large adjacent lymph nodes. There is no dilatation of the main pancreatic duct due to its location superior to the papilla. The bulky tumor is not completely clear if only arising from the pancreas or with a component of lymphadenopathy. Although atypical size and distribution, pancreatic adenocarcinoma was favored, with some considerations for lymphoma as a differential diagnosis. 

Endoscopic ultrasound confirmed adenocarcinoma of the pancreas.