Abdominal pain w/poss mass and enlargement of pancreatic tail

[ShawnP]

I have been experiencing abdominal pain for about 6 weeks.  URQ that radiates around my back.  My physician ordered an abdominal US thinking it was possibly gallbladder, which I did to based on my symptoms.  US was normal except they weren't able to see my pancreas clearly due to gas obstruction, so I had a CT done w/o contrast.  The report says the following:

The pancreas is homogenieous in texture throughout w/ no hypodensities noted.  There is a fullness in the pancreatic tail, which has a maximum AP dimension of 2.9 cm.  The other areas of the pancreas have normal configuration and size.  The liver, gallbladder and common bile duct appear to be normal. The adrenal glands, kidneys, ureters are normal.  There is minimal calcified plaque in the aorta.  There is no retroperitoneal or mesenteric lymphadenopahty.  The stomach and bowel loops are normal
Impression:  There is an elargement of the tail fo the pancreas.  This regions has homogenieous texture and mass is not discretely visualized, however MRI of the pancreas recommended with and without IV contrast to exclude a mass lesion within the tail of the pancreas.

I had my MRI yesterday and don't have that report yet.  My pain has worsened over the last 2 weeks and I can control it with Darvocet, however I'd like to be pain free.  My other symptoms are fatigue, abdominal bloating, constipation/diahrrea,gas and feeling of pressure just below my ribcage that's worse when I lay down. (I've had a TAH and appendectomy)  What is your impression, based on this limited amount of information.  Could this be something serious such as cancer?

Thank you for your time,
Shawn

[Kevin Pho, MD]

The ultrasound is typically not the best test to evaluate the pancreas.  I agree with the MRI.  If inconclusive, an endoscopic ultrasound can be considered.

The disease to rule out of course is cancer.  Other possibilities can be a cyst or pseudocyst.  The MRI test should be pretty sensitive in ruling out a pancreatic tumor.  

This question can be discussed with your personal physician, or in conjunction with a gastroenterology 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.
kevinmd_

[sdp4314]

Thank you for your response.  I received my MRI results today and there is a soft tissue mass within the pancreatic tail and a cyst on the posterior side of the tail.  Doc is sending me to pancreatic specialist and ordering tumor markers? bloodwork to r/o cancer.  My appt is on the 12/11, so it looks like I'm heading in the right direction for dx and treatment.

Sincerely,
Shawn