SONOWORLD : A very small tumor in the pancreatic head

Username

Password

189,629 Registered Members as of 11/30/2021.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Abdomen » Pancreas

A very small tumor in the pancreatic head

« Back to Listing

Author(s) :

Chaitali Shah, FRCR

Presentation A 78 year old woman presents with complaints of progressively increasing jaundice and with pain in the abdomen of one month duration. A transabdominal ultrasound was performed.

Caption: Sagittal scan in the region of the gallbladder.

Description: A distended gallbladder is noted. The common bile duct is dilated and shows abrupt termination. A rounded hypoechoic structure is seen distal to the duct.

Caption: Transverse image in the region of the gallbladder

Description: The rounded mass, which was seen in relation to the dilated common bile duct is noted again [between calipers]. The gallbladder shows the presence of a calculus.

Caption: Transverse view of the liver.

Description: Mild dilatation of the intrahepatic biliary radicles noted.

Caption: T2 weighted MRI image.

Description: The pancreatic head shows a very small intrapancreatic hypointense mass.

Caption: Transverse MRI image.

Description: The hypointense intra-pancreatic mass is seen again in this image.

Differential Diagnosis Terminal bile duct tumor, tumor in the head of pancreas, terminal bile duct calculus [although very unlikely]

Final Diagnosis A small tumor in the head of pancreas obstructing the terminal bile duct. This was an adenocarcinoma.

Discussion This case here highlights the importance of finding an abruptly terminating bile duct. The additional finding of an associated mass suggets that the disease process could either be a cholangiocarcinoma of the terminal duct or a pancreatic tumor. Further imaging would help to arrive at a final diagnosis.

Follow Up Further imaging [ERCP and MRI] was performed which showed a small mass in the head of the pancreas, just next to the terminal portion of the CBD, obstructing it. This mass proved to be an adenocarcinoma and the patient was operated upon.

Other contents by this AuthorOther Cases in This Category

Abdomen >> Pancreas

Acute focal pancreatitis
A 30 year old man presented with a history of a one day non-radiating pain in the epigastrium and nausea. He has a history of significant alcohol consumption.

Chronic pancreatitis
A 55 year old woman with a history of significant alcohol abuse and repeated episodes of upper abdominal pain. An abdominal ultrasound was performed.

Malignancy of pancreatic head
A 50 year old man presents with progressive, painless obstructive jaundice. An abdominal ultrasound was performed.

Pancreatic head malignancy II
A 50 year old man presents with progressive, painless obstructive jaundice. An abdominal ultrasound was performed.

Pancreatic intra-ductal papillary mucinous tumor
An 82 year old woman presented for abdominal ultrasound as a part of her diagnostic work-up for abdominal pain. Her complaints were of one month duration and she also experienced loss of ...

Acute pancreatitis of parasitic etiology due to Ascaris lumbricoides
18 years old female with abrupt onset of intense epigastric pain in morning, continuing throughout day. On admission to emergency service ultrasound of the abdomen was immediately ordered.

Acute biliary pancreatitis and cholelithiasis and cholecholithiasis
23 year old female patient with pain in the left upper abdomen. An ultrasound examination was requested to rule out renal stones.