Case 5: 69 Man with vogue upper abdominal pain

מרצה: Tal Arazi-Kleinman M.
Diagnostic Imaging Department, Shiba Medical Center, Sackler Medical School, Tel Aviv University

 

History:

  • 69 y.o. Man with vogue upper abdominal pain for several month without any weight loss, vomiting, constipation or other complains send to do an abdominal CT.

Figure 1a
Legends
Figure 1(a-c): (a) Pre-contrast enhancement axial CT image of the upper abdomen shows an ill-defined mass with a small calcification at the tail of the pancreas (arrow), isodense to normal pancreatic parenchyma.

Figure 1b
(b) Dynamic CT enhancement axial image in the arterial phase at the same level shows enhancement of the mass (arrow).

Figure 1c
(c) A contrast enhanced axial CT image in the porto-venous phase at a higher level than figures 1a and 1b shows multiple hypodense lesions in both lobes of the liver representing hemorrhage in the metastatic liver lesions (arrow).

What is the most likely diagnosis?

A. Pancreatic adenocarcinoma.
B. Serous cystadenoma
C. Pancreatic neuroendocrine tumour (Islet cell tumour)
D. Mucinous cystadenocarcinoma


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מרצה: Tal Arazi-Kleinman M
Diagnostic Imaging Department, Shiba Medical Center, Sackler Medical School, Tel Aviv University