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• W2921216228 abstract "A silent solid intraductal adenocarcinoma of pancreas is 4th leading cancer related death in US. The survival rate in 5 years is barely 6%. Here, we present 45 year old asymptomatic female with intermittent constipation and abdominal pain for one month with Obstructive Jaundice with pancreatic ductal adenocarcinoma (PDAC )with liver metastasis. A 45 year old Female in healthy athletic state presented with constipation and lower intermittent colicky abdominal pain on and off with obstructive jaundice with 7 lb unintentional weight loss for a month. On general exam, thin lady with jaundice with some scratch marks on the body. CMP showed total Bilirubin 9, ALP 306, AST 246, ALT 656, lipase 61,CA 19-9: 5329 and CEA: 4.7.CT (Abdomen and Pelvis with Contrast )showed 2.8 cm hypodense lesion in the hepatic dome and 8 x 4.6 cm irregular solid mass involving the pancreatic body extension to the celiac axis and superior mesenteric artery(Figure-1).Cholangiogram showed long segment (3-4 cm) distal CBD stricture with dilatation of mid and proximal CBD with dilated intra-hepatics(figure-2).EUS-FNA showed malignant cells: ductal adenocarcinoma(Figure-3). Due to biliary obstruction ERCP was done and a stent was placed in biliary tract. In our patient, as the tumor is located on the body of pancreas, symptoms are due to biliary obstruction. The solid tumor of pancreas should be in doubt whenever the patient presented with painless obstructive jaundice, new onset of DM in elderly patients, chronic smoker with back pain or recurrent chronic pancreatitis in chronic alcoholic.Proper work up should perform at least to rule out this silent killer of middle age populations.1301_A.tif Figure 1: CT scan (abdomen and pelvis with contrast) showed a heterogeneous, irregular 8 x 4.6 cm (white arrow) solid mass involving the pancreatic body with soft tissue extension to the celiac axis and superior mesenteric artery.1301_C.tif Figure 3: EUS-Guided fine needle aspiration biopsy (200x) showed ductal epithelial cells with mild atypia.1301_B.tif Figure 2: Cholangiogram showed long segment (3-4 cm) distal CBD stricture with dilatation of mid and proximal CBD with dilated intra-hepatics." @default.
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• W2921216228 date "2018-10-01" @default.
• W2921216228 modified "2023-09-27" @default.
• W2921216228 title "A Silent Solid Intraductal Adenocarcinoma of Pancreas: A Silent Killer" @default.
• W2921216228 doi "https://doi.org/10.14309/00000434-201810001-01301" @default.
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