A 79-year-old male with a history of hypertensive heart disease in atrial fibrillation and transitional cell carcinoma of the bladder treated by transurethral resection.
The patient was a smoker of about 20 cigarettes per day up to 70 years old and is drinker of about 80 grams of ethanol per day.
She was admitted to our service due to epigastric abdominal pain of approximately 3 weeks duration, with a loss of approximately 8 kg in the last 2 months.
At admission, an abdominal CAT with celiac axis was performed with contrast enhancement, in which an irregular lesion in the pancreatic body-head was identified, of approximately 3 cm in diameter, with involvement of vascular structures (fundamentally pancreatic).
The diagnosis of suspected pancreatic tumor, probably pancreatic adenocarcinoma, is established.
EUS was performed, confirming the presence of a solid lesion in the head-body transition of the pancreas, with irregular appearance, hypoechoic, with poorly defined borders.
Vascular inversion described in abdominal CT was confirmed.
During EUS an elastographic study was performed.
The basal analysis showed a heterogeneous pattern of blue predominance, with geographic distribution.
In the second generation elastography study, an elasticity coefficient of 25.46 and an A value of 0.01% were observed.
Finally, a 22G needle aspiration puncture was performed, revealing findings consistent with adenocarcinoma of the pancreas.
The patient is treated conservatively with medical therapy for cancer, which is considered to be an unresectable tumor due to vascular involvement and a patient who cannot be operated due to basal cardiac disease.
After a 3-month follow-up, the patient is in tumor progression (at last follow-up, the presence of liver metastases) and in palliative oncological treatment was observed.
