PMC1800859_01
Abdominal CT scan. Abdominal CT scan demonstrating a left-sided renal tumour (thick arrow) and a polypoidal mass in the wall of the second part of the duodenum (thin arrow) arising from the pancreas (not shown).
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F1
Surprisingly, this demonstrated a large left renal mass with evidence of left adrenal and lung metastases, and a polypoidal mass in the medial wall of the second part of the duodenum arising from the pancreas (Figure 1).
Coeliac angiogram. Figure 2A is an angiogram of the coeliac trunk. This demonstrates a highly vascular mass around the duodenum and pancreas and its blood supply from the pancreaticoduodenal arteries. Numerous other small vascular blushes are seen which represent further pancreatic metastases. Figure 2B is taken post- embolisation and demonstrates successful occlusion of the tumour's blood supply.
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F2
This was performed successfully via occlusion of the anterior and posterior pancreaticoduodenal vessels using coils (Figure 2A and 2B).
PMC1800859_02
Abdominal CT scan. CT scan demonstrating the presence of a mass in the area of the pancreatic head and protruding into the duodenum (thick arrow) - note the previous left nephrectomy (thin arrow).
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F3
A CT scan of the chest and abdomen, and a bone scan revealed a pancreatic mass invading the duodenum (Figure 3) but no metastatic disease elsewhere.