The patient underwent multiple endoscopies for coagulation of ulcers. The clinical course, however, became complicated with the development of pneumonia and peritonitis that resulted in death. A limited autopsy was performed. Pancreatic ductal adenocarcinoma was noted at the pancreatico-jejunostomy anastomosis corresponding to the PET and CT soft tissue abnormalities. Discussion Pancreatic carcinoma has a poor prognosis.
Many patients present late in the course of disease with nonspecific signs and symptoms.
The more common clinical features include weight loss, anorexia, and painless jaundice. Serum tumor marker CA19-9 is insensitive and nonspecific for screening. In summary, FDG PET is useful in staging and determination of resectability of pancreatic cancer at the time of initial diagnosis as well as in re-evaluation of patients after therapy and in differentiating malignancy from chronic pancreatitis. Friess H, et al. Zimny M, et al.