Retropancreatic mass How to treat?

[indrasis123]

Earlier I wrote about the fever after stent in bile duct due to the compression of retropancreatic mass on Bile duct.(Primary site OVCA,2006 March) USG showed that there is no more invasion except the single mass. Though the mass has become quite large 6cm x 7cm.
Now My mom has had no symtoms except extreme fatigue after the prolonged intermittent fever which has gone now after extensive antibiotic therapy.

Now would we treat her ?
Is surgery an option? Radiation? IF chemo which one is the best now? What about Avastin?  
She has already received 6 cyles taxol+Carbo, Doxil+cyclophosphamide, Gem + Carbo 4 cycles.
One important finding is that earlier in march 2006 cell type was Clear cell but now FNAC from the mass showed Papillary serous. is it possible?

[Annekathryn Goodman, M.D.]

Hi There,
what a tough problem. Until the pus is cleared and the infection is treated, it is dangerous to treat with chemotherapy. Chemotherapy will lower the white blood cell count and in the setting of active infection, the death rate from sepsis is extremely high.

If possible, the area of pus can be drained by inserting drains by interventional radiology. If that is not possible, there may be a role for surgical exploration to rinse out the infection.

as far as the pathology. Some cancers have mixed features.SO it may be that this tumor has a mixture of clear cell and serous.
best wishes

[indrasis123]

Beside this she came out of febrile state for 2 days when doctor changed her stent into a metal one from Plastic. Plastic was totally blocked by WHITE PUS and it came out when metal stent was insterted. Dcotros said this was the Source of her fever. But again after 2 days Fever started coming in and now it is persistent. Doctors are saying PUS is still inside her body....Now how to treat the Infection...Fever is for almost 2 1/2 months now.