case_images: PMC6432679_01
case_images: Computed tomography (CT) scan image of Case No. 0000424 (Case 1), who received Chinese herbal medicine (CHM) treatment only and had a prolonged survival of 9 years.. Note: The first CT scan image dated October 15, 2001. At the head of the pancreas, there is enlargement and bulkiness with slight mass effect, displacing the adjacent structures. This area of the pancreas enhances in homogeneously. The appearances are highly suspicious of a tumor mass. Continuous CT scans were made all along the CHM treatment. The last observable CT dated January 13, 2009, with the pancreatic tail is atrophic. Pancreatic duct was prominent. Relatively reduced enhancement is also seen in the pancreatic body. No definite mass lesion is seen. Small cortical cysts are seen in both kidneys. No hydronephrosis associated.
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case_images: PMC6432679_01_10.1177_1534735419828836-fig1.jpg
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case_images: Pancreatic head cancer was confirmed after ultrasound scan, CT scan, and ERCP (Figure 1).
case_images: PMC6432679_02
case_images: Computed tomography (CT) scan image of Case No. 0000942 (Case 2), with liver metastasis, who survived 8 years with only Chinese herbal medicine (CHM) treatment after surgery.. Note: The first CT scan dated January 24, 2006 (Figure 2A), and September 13, 2012 (Figure 2B). The head, neck, and proximal part of body of pancreas are absent, likely resected. The distal body and tail of pancreas were unremarkable, and the pancreatic duct appears not dilated (SE 10, IM 21 to 23). Figure 2B dated September 13, 2018, shows that previous Whipple operation was evident. The pancreatic head and uncinate process and gallbladder were absent. The common bile duct and the intrahepatic bile ducts in both lobes were not dilated. The remaining pancreas show normal size and configuration with homogeneous enhancement pattern. No focal mass lesion was seen. No dilated pancreatic was seen. The peripancreatic fat planes were preserved. Two figures differ slightly, which evidenced the effectiveness of prolonging CHM for survivorship.
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case_images: CT examination confirmed pancreatic head carcinoma (Figure 2).
case_images: PMC6432679_03
case_images: Computed tomography (CT) scan image of Case No. 0001021 (Case 3), with a low-density carcinoma block in the pancreatic body, and liver metastasis. The patient survived for 3 years with Chinese herbal medicine (CHM) treatment alone. Death occurred 1 year after stopping CHM treatment.. Note: The first CT scan dated August 28, 2006. The mild enhancing tumor in the body of pancreas was still noted (SE 9, IM 20-21, film 8). It caused obstruction to the main pancreatic duct with associated atrophic change in the distal part of pancreas. No infiltration of the surrounding peripancreatic fat was seen. No evidence if vascular encasement was noted. Lesion measures 3.2 x 1.6 cm in transaxial diameter and 1.8 cm in craniocaudal extent. It also showed no obvious interval change compared with CT (last measurement: 3.7 x 1.8 x 1.9 cm) allowing for interstudy difference. No other focal pancreatic lesion was noted. Spleen was not enlarged. Both kidneys were normal in size and attenuated. No renal stone or hydronephrosis was seen. Both adrenal glands were not enlarged. The last observable CT scan dated June 5, 2007. They all showed very mild interval enlargement compared with previous measurement. No new lesion was seen in the liver. Biliary tree was not dilated. Portal vein was patent. Gallbladder was unremarkable. No calcified gallstone was seen. Spleen was not enlarged. The known hypodense nodule in the body of pancreas in last CT scan (lesion H) was still noted. It appeared to have mild decrease in size (SE 6, IM 21, file 5). They caused obstruction to the pancreatic duct with atrophic change in distal body and tail of pancreas. Posterior aspect of lesion closely abuts the splenic vessel with encasement. The rest of pancreas was unremarkable.
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case_images: CT scan of Case 3 (female, age 67 years) revealed pancreatic body carcinoma with multiple liver metastases (Figure 3).