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OpenAthens Shibboleth
Special Feature
September 2010

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations: The Elkins Pancreas Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine (Drs Dorsey and Fisher), and Department of Pathology, Saint Luke's Episcopal Hospital (Dr Taggart), Houston, Texas.




Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Surg. 2010;145(9):913. doi:10.1001/archsurg.2010.172-a

A 54-year-old woman presented with chronic intermittent sharp midepigastric abdominal pain. She denied having jaundice or a change in her bowel function but admitted to a 5.4-kg weight loss over 3 months. Medical, surgical, family, and social histories were unremarkable. There was no history of neurofibromatosis 1. The results of physical examination and routine laboratory tests, including liver function tests, were normal. A right upper quadrant ultrasonographic and computed tomographic (CT) scan with contrast revealed a 1.4-cm enhancing lesion in the head of the pancreas without duct dilation (Figure 1).

Figure 1.
Image not available

Preoperative computed tomographic scan showing a 1.4-cm enhancing lesion in the head of the pancreas.

What Is the Diagnosis?

A.  Pancreatic adenocarcinoma

B.  Neuroendocrine carcinoma

C.  Pancreatic schwannoma

D.  Renal cell carcinoma metastatic to the pancreas