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Abd CT: 4.0 cm mass posterior aspect of body of pancreas suspicious for malignancy. Mass infiltrates celiac axis as well as proximal hepatic artery. Marked narrowing is seen of distal splenic vein and portal vein. No adenopathy seen. Small bilateral pleural effusions and a subcapsular fluid collection surrounding the spleen. Numerous low density lesions in liver c/w cysts.
MRI - enlarging subcapsular hematoma in spleen.
Chest X-Ray: negative for malignancy.
Fine needle biopsy body of pancreas lesion: adenocarcinoma.
Chemotherapy: Started chemotherapy (5-FU) concurrent with radiation therapy.
Radiation: 18 MV IMRT, 45 Gy, 1.8 Gy fraction for 25 fractions to the abdomen. Boost dose 18 MV IMRT, 5.4 Gy, 1.8 Gy fraction for 3 fractions, total dose 50.4 Gy.