A Thought-Provoking Case of Successfully Treated Carcinoma of the Head of the Pancreas with Metachronous Lung Metastasis: Impact of Distal Spleno-Renal Shunt for Regional Invasion on Long-Term Period after Pancreaticoduodenectomy

Figure 1

Pancreatic cancer with regional invasion into vessels. (a, b) Enhanced computed tomography shows a hypovascular mass in the pancreatic head (red arrow) and marked dilation of the main pancreatic duct of the distal pancreatic parenchyma (yellow arrows). (c) The pancreatic tumor (red area) markedly involves the confluence of the superior mesenteric vein, portal venous trunk, and splenic vein. (d) The inferior mesenteric vein flows into the superior mesenteric vein, not the splenic vein. There is no evidence of cancer at unresectable sites or distant metastases. GB: gallbladder; IMV: inferior mesenteric vein; LGV: left gastric vein; LRV: left renal vein; IVC: inferior vena cava; MCV: middle colic vein; SMA: superior mesenteric artery; SMV: superior mesenteric vein; SpA: splenic artery; SpV: splenic vein.

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