case_images: PMC9294444_01
case_images: Axial view of FDG-PET/CT: (A) Hypermetabolic activity in the swollen pancreas with SUVmax of 3.0; (B) Mild hypermetabolic activity surrounding the pancreas; (C) Mild hypermetabolic activity in the mesenteric area with SUVmax of 1.9.
case_images: fsurg-09-894272-g001.jpg
case_images: PMC9294444_01_fsurg-09-894272-g001.jpg
case_images: F1
case_images: Whole-body fluorodeoxyglucose PET/CT scans showed pancreatic thickening along with increased fluorodeoxyglucose tracer intake, pancreatic duct dilation, and a mild increase in the metabolic activity of lymph nodes in the peripancreatic and mesenteric areas (Figure 1).
case_images: Micrographs of the surgical specimens and immunohistochemical examination results. (A,B) Sections of the pancreas showed atypical clear cells monomorphonuclear with bright cytoplasm (H&E, x20, x100). (C-E) HE staining image of the peripancreatic lymph node, sections of the liver, and the omental tissue showed histological features similar to those of the pancreatic sections (H&E, x100, x100, x100). (F-I) Immunohistochemical examination of surgical specimens showed neoplastic cells with CK (+), CA9 (+), CD10(+), and Vimentin (+) (x100).
case_images: fsurg-09-894272-g002.jpg
case_images: PMC9294444_01_fsurg-09-894272-g002.jpg
case_images: F2
case_images: The results of histopathological and immunohistochemical analyses are provided in Figure 2.
case_images: Newly-occurred lung metastases after metastasectomy. (A) No lung metastases before metastasectomy. (B) The metastatic lesion in the right lower lobe (arrow) 10 months after metastasectomy.
case_images: fsurg-09-894272-g003.jpg
case_images: PMC9294444_01_fsurg-09-894272-g003.jpg
case_images: F3
case_images: In June 2020, the high-resolution chest CT re-examination revealed new nodules in the basal segment of the right lower lobe (Figure 3).
case_images: Enhanced CT scan showing multiple abnormal enhancement lesions (arrows). (A) The mass with heterogeneous enhancement in left kidney area. (B) A 'target-like' sign and heterogeneous enhancement of the nodule in liver. (C) Multiple enlarged lymph nodes in hepatic hilar region.
case_images: fsurg-09-894272-g004.jpg
case_images: PMC9294444_01_fsurg-09-894272-g004.jpg
case_images: F4
case_images: In September 2020, a reexamination of the abdominal enhanced CT showed that there were multiple new-onset metastatic lesions in the left renal area, the liver, and the lymph nodes in the hilar area (Figure 4).