Pancreatic body cancer presenting with dysphagia and palpable abdominal mass being mistaken for gastric gastrointestinal stromal tumor: “Case report”

INTRODUCTION AND IMPORTANCE: Body and tail pancreatic cancers account for one third of pancreatic ductal adenocarcinomas (PDACs). Dysphagia is an extremely rare manifestation of pancreatic cancer that may follow direct invasion of primary pancreatic cancer to esophagus. Pancreatic cancer can be confused with either pancreatic or peripancreatic lesions like gastrointestinal stromal tumors (GISTs) on diagnostic computed tomography (CT) scans. Undifferentiated pancreatic cancer, which is a rare variant of pancreatic ductal adenocarcinoma rarely, present with palpable abdominal mass. The aim of this case report is to show the rare presentation of this deadly malignancy with dysphagia and palpable abdominal mass which was mistaken on CT scan for gastric gastrointestinal stromal tumor. PRESENTATION OF THE CASE: A 60 years old male farmer presented with progressive dysphagia to solid food of 3 months duration. He has no history of smoking, diabetes or alcohol intake. Physical examination showed hard epigastric mass with poorly defined borders. Imaging suggested gastrointestinal stromal tumor found to be primary pancreatic body cancer at laparotomy. Biopsy later confirmed undifferentiated pancreatic cancer. DISCUSSION: The presentation of pancreatic ductal adenocarcinoma is nonspecific. Presence of clinical symptoms indicates advanced disease. Pancreatic body cancer has poor prognosis due to late presentation of the disease as compared to its counter pancreatic head cancer. CT scan has 85% diagnostic accuracy. CONCLUSION: Both surgeons and radiologists should be familiar with common and uncommon CT scan findings of pancreatic ductal adenocarcinoma as this can avoid unnecessary invasive investigation or treatment.