case_images: PMC4929393_01
case_images: Abdominal CT. Pancreatic tumor mass compared to the celiac region.
case_images: crg-0010-0174-g01.jpg
case_images: PMC4929393_01_crg-0010-0174-g01.jpg
case_images: F1
case_images: Unexpectedly, a rounded and well-delimited pancreatic tumor was discovered on the CT scan (fig. 1).
case_images: EUS. Rounded lesion with clear borders (arrow).
case_images: crg-0010-0174-g02.jpg
case_images: PMC4929393_01_crg-0010-0174-g02.jpg
case_images: F2
case_images: On endoscopic ultrasound (EUS), this homogeneous and hypoechoic lesion was separated from the liver and stomach by a hyperechoic border (fig. 2).
case_images: Appearance of a hypoechoic cavity within the lesion during puncture using EUS (arrow).
case_images: crg-0010-0174-g03.jpg
case_images: PMC4929393_01_crg-0010-0174-g03.jpg
case_images: F3
case_images: During the puncture, a hypoechoic cavity appeared inside the lesion (fig. 3).
case_images: A Positive staining with BCL10. x200. B Negative staining with CK7. There is a cytoplasmic background without membrane staining. x100.
case_images: crg-0010-0174-g04.jpg
case_images: PMC4929393_01_crg-0010-0174-g04.jpg
case_images: F4
case_images: Immunohistochemically, the tumor cells were positive for cytokeratin AE1/AE3, epithelial membrane antigen, and BCL10 (fig. 4A), and negative for CK7 (fig. 4B), CK20, chromogranin, and synaptophysin, consistent with ACC.
case_images: Abdominal CT. Bulky tumor mass in the pancreatic head measuring 80.3 mm (long axis).
case_images: crg-0010-0174-g05.jpg
case_images: PMC4929393_01_crg-0010-0174-g05.jpg
case_images: F5
case_images: A scan showed an 80-mm cephalic lesion in the pancreas composed of tissue and cysts, which was responsible for a retrodilation of the main pancreatic duct (fig. 5).
case_images: Therapeutic response obtained after 6 cycles of GEMOX treatment.
case_images: crg-0010-0174-g06.jpg
case_images: PMC4929393_01_crg-0010-0174-g06.jpg
case_images: F6
case_images: Following 6 cycles of chemotherapy, the primary lesion on the pancreatic head had disappeared (fig. 6) and a decrease in size of the liver metastases was observed.