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JAMA Surgery Clinical Challenge
December 2015

A Painless Mass in the Pancreas: Incidental Finding

Author Affiliations
  • 1Department of Visceral Surgery, Cantonal Hospital Lucerne, Switzerland
JAMA Surg. 2015;150(12):1189-1190. doi:10.1001/jamasurg.2015.1244

We present the case of a 40-year-old man who was admitted to our hospital with acute abdominal pain on the right flank. A similar episode had occurred 1 month before admission that improved spontaneously.

A physical examination did not reveal any clinical abnormities, but the patient reported dysuria and abnormally frequent urination. A computed tomographic scan of the abdomen revealed nephrolithiasis with a 4-mm kidney stone on the right side and a slightly congested right kidney. During computed tomography, we incidentally found a 10 × 10 × 8-cm mass in the tail of the pancreas (Figure 1), as well as thrombosis of the splenic vein. His medical history was uneventful, and there was no weight loss. However, the patient’s father had died of a pancreatic carcinoma the previous year at the age of 65 years. The patient’s laboratory values, including cancer antigen 19-9 and carcinoembryonic antigen levels, were normal.

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