case_images: PMC7569435_01
case_images: 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.
case_images: CJGH2020-8679751.001.jpg
case_images: PMC7569435_01_CJGH2020-8679751.001.jpg
case_images: fig1
case_images: 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)).
case_images: Trend of neoplastic markers: CEA (a) and Ca 19.9 (b).
case_images: CJGH2020-8679751.002.jpg
case_images: PMC7569435_01_CJGH2020-8679751.002.jpg
case_images: fig2
case_images: Serum levels of CEA and Ca 19.9 were 721 ng/mL and 11.200 U/mL, respectively (Figures 2(a) and 2(b)).
case_images: Radiological evaluation before surgery: primary pancreatic lesion (a) and liver metastasis (b-d).
case_images: CJGH2020-8679751.003.jpg
case_images: PMC7569435_01_CJGH2020-8679751.003.jpg
case_images: fig3
case_images: 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)).
case_images: Disease relapse: radiological evaluation of primary pancreatic lesion (a), liver (b), and lung metastasis (c-d). The red arrows indicate the metastatic lesions.
case_images: CJGH2020-8679751.004.jpg
case_images: PMC7569435_01_CJGH2020-8679751.004.jpg
case_images: fig4
case_images: At the third radiological evaluation after surgery, the liver and lung relapse was observed (Figures 4(a)-4(d)).