A case of pancreatic cancer in the vicinity of a pancreatic stone

Abstract

A 50-year-old man presented to our department because of abdominal pain. He had alcoholic chronic pancreatitis with pancreatic stones and diabetes mellitus, and was being treated by a nearby doctor. The level of tumor marker CA19-9 rose to 3228U/ml. Abdominal enhanced CT showed a 20×14mm hypovascular tumor, in the pancreatic head near a 20×10mm pancreatic stone. Caudal pancreatic duct dilation was noticed. An FDG-PET hot spot corresponded with the tumor location shown by the CT scan. We diagnosed this patient as having pancreatic cancer and performed surgery. The final diagnosis was pancreatic cancer (f Stage III). When a pancreatic cancer occurs near a pancreatic stone, as in this case, it would be easy to overlook the pancreatic duct dilation caused by the cancer, obtained as indirect findings for dilation by the pancreatic stone, and thus an early diagnosis of pancreatic cancer would be difficult. During follow-up in patients with pancreatic stones, it is important to pay particular attention to the possibility of pancreatic cancer in the vicinity of pancreatic stones.