Ultrasound Pictures of “Pancreatic Tumor”

Clinical manifestations: The tumor may remain asymptomatic for some time,
depending on its location (tail of pancreas). In most cases the tumor is no longer
curable by the time symptoms appear, particularly if there are detectable local or
distant metastases and/or vascular invasion. Symptoms may include jaundice,
inferior vena cava syndrome, and upper abdominal pain.

Diagnosis: Imaging studies consist of sonography, ERCP, and CT if necessary.
Percutaneous FNAB is done only to confirm the diagnosis in inoperable cases.
A histologic diagnosis is made at operation.

Sonographic findings:
x Hypoechoic mass
x Dilated pancreatic duct
x Obstructed bile duct

Accuracy of sonographic diagnosis: The changes associated with a pancreatic tumor are clearly detectable with ultrasound, although pancreatitis cannot always be distinguished from a tumor. If there is any doubt, a prompt exploratory laparotomy is advised.

“Ultrasound Pictures” of Metastasis from a pancreatic
tumor. The metastasis (M) is compressing the hepatic artery (arrow), and the
primary tumor (T) is compressing the pancreatic duct (DP), which is markedly
expanded. VL = splenic vein, TR = celiac trunk