A 65-year-old female, was sent to our hospital for weight loss of 8kg in four months, right abdominal pain and asthenia. Clinical evaluation highlighted a hepatomegaly up to pelvis with hard consistency on palpation. Serum laboratory studies showed the following abnormal values: pancreatic amylase 84U/L, aspartate aminotransferase 69U/L, alanine aminotransferase 61U/L, gamma-glutamyl transferase 214UI/L, alkaline phosphatase 191U/L and carbohydrate antigen 19–9104U/ml. Abdomen Multi-detector computed tomography imaging axial (Fig. 1), coronal MIP and VRT reconstruction (Fig. 2A and B) demonstrated multiple hepatic nodules (arrows) occupying almost all liver parenchyma and a single nodule at the pancreatic tail (arrowhead). US-guided liver biopsy demonstrated the diagnosis of metastatic pancreatic adenocarcinoma. Patient has just started chemotherapy with nabplaclitaxel and gemcitabine, with the aim of reduction of tumour masses and pain relief.
Liver metastases from pancreatic cancer are present in 37–41.9% of cases already in the first clinical diagnosis.1 Therefore, an accurate evaluation of possible locoregional and/or distant metastases in patients with pancreatic cancer is crucial, in order to indicate clinical treatment.1–3
Authors’ contributionsUmberto G. Rossi: write paper, diagnosis, images.
Andrea DeCensi: review paper, treatment.
FundingThe authors declare that there is no funding.
Conflict of interestThe authors declare that there is no conflict of interest.
