PMC7569435_01
Staging: radiological evaluation of primary pancreatic lesion (a) and liver metastasis (b-d). The green arrows indicate the biopsied lesions and the red arrows indicate the liver lesions.
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fig1
A computed tomography (CT) scan of the abdomen revealed a lesion of 4 cm in diameter localized in the head of pancreas with the presence of venous involvement of the superior mesenteric vein (Figure 1(a)) without a clear cleavage plane from the descending part of the duodenum and an initial dilatation of the intrahepatic bile duct. Six secondary liver lesions were concomitant (Figures 1(b)-1(d)).
Trend of neoplastic markers: CEA (a) and Ca 19.9 (b).
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fig2
Serum levels of CEA and Ca 19.9 were 721 ng/mL and 11.200 U/mL, respectively (Figures 2(a) and 2(b)).
Radiological evaluation before surgery: primary pancreatic lesion (a) and liver metastasis (b-d).
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fig3
A new CT scan showed dimensional stability of both hepatic and pancreatic lesions associated with a prevalence of necrotic areas (Figures 3(a)-3(d)).
Disease relapse: radiological evaluation of primary pancreatic lesion (a), liver (b), and lung metastasis (c-d). The red arrows indicate the metastatic lesions.
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fig4
At the third radiological evaluation after surgery, the liver and lung relapse was observed (Figures 4(a)-4(d)).