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What Does " Heterogenous Hypoechoic Mass Near The Head Of Pancreas" Mean?

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Posted on Sat, 1 Mar 2014
Twitter Sat, 1 Mar 2014 Answered on
Twitter Fri, 21 Mar 2014 Last reviewed on
Question : nullMy father has a history of chronic pancreatitis, pseudosyst, smoking and alcohol abuse, bile duct stones and kidney stones. He is in the hospital now and they did a CT and found a 3.3x2.8 cm heterogenous hypoechoic mass near the head of the pancreas. His ca 19-9 is normal however. What could it be?
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Answered by Dr. Ashish Verma (1 hour later)
Brief Answer: it can still be pancreatic cancer Detailed Answer: Hi, Thanks for writing to HCM. This is Dr. Ashish Verma, a general surgeon, answering to your query. Though Serum CA 19-9 is the most extensively validated pancreatic cancer biomarker, CA 19-9 serum levels have a sensitivity and specificity of only 79-81% and 82-90% respectively for the diagnosis of pancreatic cancer. But, pre-operative CA 19-9 serum levels provide useful prognostic information as patients with normal levels (<37 U/mL) have a prolonged median survival (32-36 months) compared to patients with elevated levels (>37 U/mL) (12-15 months). Also, a CA 19-9 serum level of <100 U/mL implies likely resectable disease whereas levels >100 U/mL suggest unresectablity or metastatic disease. So, now the next step should be either contrast mri or ct guided biopsy to conclusively reach a diagnosis. Hope, that i have answered to all your queries. If you have further queries, i will be glad to answer them. Regards Dr. Ashish Verma
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Ashish Verma (2 hours later)
Thank you i will see what the ercp biopsy results are
doctor
Answered by Dr. Ashish Verma (15 minutes later)
Brief Answer: You are welcome Detailed Answer: Hi, Glad that my answers have been of help to you. If you dont have further queries, you may close this discussion and rate the response. Regards Dr. Ashish Verma
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Ashish Verma

General Surgeon

Practicing since :2008

Answered : 1290 Questions

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What Does " Heterogenous Hypoechoic Mass Near The Head Of Pancreas" Mean?

Brief Answer: it can still be pancreatic cancer Detailed Answer: Hi, Thanks for writing to HCM. This is Dr. Ashish Verma, a general surgeon, answering to your query. Though Serum CA 19-9 is the most extensively validated pancreatic cancer biomarker, CA 19-9 serum levels have a sensitivity and specificity of only 79-81% and 82-90% respectively for the diagnosis of pancreatic cancer. But, pre-operative CA 19-9 serum levels provide useful prognostic information as patients with normal levels (<37 U/mL) have a prolonged median survival (32-36 months) compared to patients with elevated levels (>37 U/mL) (12-15 months). Also, a CA 19-9 serum level of <100 U/mL implies likely resectable disease whereas levels >100 U/mL suggest unresectablity or metastatic disease. So, now the next step should be either contrast mri or ct guided biopsy to conclusively reach a diagnosis. Hope, that i have answered to all your queries. If you have further queries, i will be glad to answer them. Regards Dr. Ashish Verma