PMC5852301_01
Staging CT-Scan: Tumor of the tail of the pancreas invading the spleen (marked with a red arrow).
gr1.jpg
PMC5852301_01_gr1.jpg
fig0005
Staging chest and abdominal computed tomography (CT-Scan) (Fig. 1) diagnosed a hypodense lesion in the tail of the pancreas with 4.5 x 4 x 3.6 cm, which invaded the spleen, Gerota's fascia, left adrenal and anterior aspect of the left kidney, and multiple regional and para-aortic nodules.
Pathological analysis of the umbilical nodule: A-Hematoxylin-eosin 40x; B-Hematoxylin-eosin 100x. The images show an adenocarcinoma composed of small and medium-sized glandular structures with pleomorphic nuclei with desmoplastic stroma.
gr2.jpg
PMC5852301_01_gr2.jpg
fig0010
Emergency department CT-Scan, no contrast administration due to renal insufficiency: A-Thickening of sigmoid colon with signs of perforation (marked with the red arrow).
gr3.jpg
PMC5852301_01_gr3.jpg
fig0015
An abdominal CT-Scan was promptly ordered (Fig. 3), diagnosing a pneumoperitoneum and thickening of the sigmoid colon with signs of perforation.