Hematemesis as the initial complication of pancreatic adenocarcinoma directly invading the duodenum: A case report

Figure 1 A soft tissue mass (3 cm×3 cm in size) over the pancreatic head (arrow), duodenal infiltration (arrowhead), and superior mesenteric vein encasement shown by abdominal computed tomography.

Figure 2 A soft polypoid mass protruding over the anterior wall of the duodenal bulb with partial obstruction of the second portion of the duodenum shown by upper gastrointestinal endoscopy.

Figure 3 Morphology of adenocarcinoma and pancreatic lesion. A: Biopsy of the duodenal tumor via upper gastrointestinal endoscopy revealed a picture of adenocarcinoma cells in an acinar pattern; B: Biopsy of the pancreatic head tumor via computed tomography-guidance showed moderately differentiated adenocarcinoma cells infiltrating into the collagenous stroma (hematoxylin and eosin stain; magnification ×200).