Widespread portal venous thrombosis in a patient with pancreatic cancer

Abstract

Pancreatic cancer is a risk factor for the development of portal vein thrombosis because pancreatic lesions sometimes compress and/or directly invade the portal vein. We herein present a case of pancreatic cancer with widespread thrombosis of the portal vein system. A 52-year-old male was admitted to our hospital with epigastralgia. An abdominal contrast-enhanced computed tomography scan demonstrated a non-enhanced low-density tumor in the head of the pancreas and widespread thrombus formation in the superior mesenteric and portal veins. 18F-FDG positron emission tomography showed uptake in the tumor but not in the thrombi. We diagnosed the patient with pancreatic cancer with widespread portal venous thrombosis without tumor thrombi, and pancreaticoduodenectomy with reconstruction of the portal vein was performed. Histological examinations showed that the majority of the emboli consisted of blood thrombi including a few tumor cells. Although the patient ultimately died due to multiple liver metastases, he lived for 19 months after the surgery. The present case indicates that performing radical pancreatic resection in patients with pancreatic cancer is possible, even when widespread portal venous thrombosis is present.