Computed tomography-based diagnostics might be insufficient in the determination of pancreatic cancer unresectability

Figure 6 In this 59-year-old man (case 4), 360°pancreatic ductal adenocarcinoma encasement of the superior mesenteric artery was diagnosed on computed tomography (A-D), while endoUS data described only tumor abutment with the superior mesenteric artery. A-C: Computed tomography (CT), Arterial phase, Axial images. CT showed circumferential infiltration of the SMV. The CA was intact; D: CTA. Local narrowing of the SMA at the site at which it was circumscribed by the tumor; E: Intraoperative photograph. An extended Whipple procedure was performed. There were no signs of SMA involvement during surgery. The level of resection was R1 because of the contact of the SMA with the tumor; F: CT angiography. Three months postsurgery. No relapse and no narrowing of the SMA. SMA: Superior mesenteric artery; SMV: Superior mesenteric; PV: Portal; IVC: Inferior caval; LRV: Left renal veins; CA: Celiac artery.