ENLARGED PANCREAS now normal size?

Dear Doctor.

April 2002 I had a mastectomy.  It was determined to be stage 3
I then had 8 chemotherapies,  radiation and am taking Tamoxifen.

Right after my mastectomy surgery I had a CAT scan , chest xray and bone scan.  All were  okay.  When later tested again,(I think it was a year later, after all my chemo and radiation treatments were finished)  the CAT scan showed an enlarged pancreas. Since,I have had 5 CAT scans, (with the iodine in the veins)
The first 4 showed an unchanged pancreas, still large.  Then the last CAT scan, (last October) showed to be normal size.

What to you make of this?  Do you think the chemotherapy  (4 Adromyacin & 4 Taxotere) could have made the pancreas grow, and now it has gone down?
My Oncologist told me last Oct. that he was going to just order a mammogram and a chest xray for me this April.

I am worried and would like to have ONE more CAT scan just to be sure it is okay.  It seems that if the first 4 all agreed, that the last one after that could have been read wrong.  I guess I am thinking that the majority should be nearer to being right.
Do you think I am just being overly causious?  I hate to bring this up to my Oncologist, thinking he will think I am a little weird!  Still,  I wonder.
Please give me your opinion.  Thank You,   Seven7

[Kevin Pho, MD]

It may be possible that the chemotherapy medications that you are using may lead to pancreatitis, which could lead to an enlarged pancreas.  I looked up both of the mentioned agents, and they do not commonly lead to pancreatitis, but this doesn't mean it can't happen.

If the pancreas continues to be enlarged, other possibilites would include a cyst or pseodocyst - which should be seen on a CT scan.  Blockage of the pancreatic duct can also lead to enlargement.  This can be evaluated with an ERCP or MRCP.  

These options can be discussed with your personal physician, or in conjunction with a GI evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
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