PMC5933488_01
Axial CT scan demonstrates close relationship of pancreatic neck and body mass to the celiac axis and CHA. Red arrow denotes hypoechoic mass. Narrow yellow arrow denotes CHA, narrowed by the tumor. CHA, common hepatic artery; CT, computerized tomography.
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The patient underwent seven cycles of FOLFIRINOX chemotherapy (leucovorin, fluorouracil, irinotecan, and oxaliplatin) and repeat imaging demonstrated a 2.2 cm mass in the neck of the pancreas abutting the CHA without involvement of the SMA, SMV, or PV (Fig. 1).
Sagittal CT arteriogram reveals the acute angulation of the origin of the celiac axis off the aorta. Red arrow denotes the celiac artery origin. The MAL narrowing is depicted about 2 cm distal to the celiac origin. Post stenotic dilatation is seen. There was no tumor at the MAL. MAL, median arcuate ligament.
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The proximal celiac artery origin was flattened toward the aorta with evidence of post-stenotic dilatation, likely secondary to compression by the MAL (Fig. 2).