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What Causes A Lump Around The Celiac Artery?

Posted on Mon, 29 May 2017

Question: I have a very serious condition. I was told today that I have a mass around my celiac artery, which indicates Pancreatic cancer. I had two CT scans since February and nobody saw this mass. I insisted that my GI doctor review my condition hence the cancer finding. I have 2 IPMN cysts, but they have been monitored, and for 3 years have been stable. How can cancer from the pancreas get to the Celiac Artery if I did not have Cancer in the Pancreas. This is a very bad diagnosis and I can't think of the Prognosis.

Answered by Dr. Deepak Sundriyal (55 minutes later)

Brief Answer:
Biopsy is the answer

Detailed Answer:
Hello dear. I have gone through the details.

It is quite possible that there is no tumor in the pancreas and still there is mass around the celiac artery or plexus or somewhere else. However, it needs to be confirmed by a biopsy and tumor marker test.

It is also possible that it may turn out to be something else like tuberculosis. Only a biopsy will give the answer. And please do not worry, if you are stable, the possibility of a tumor is remote.

Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (1 hour later)

Dr XXXXXXX I have a EUS scheduled for Tuesday and a MRI for this Saturday. My fear is that if it is cancer it would be non resectable. I did get most of the blood test results and things seem normal. For example my Lipase is normal. I know blood work is not the test of choice but things like carcinoembryonic antigen are also normal. As an Oncologist, where would you send patients for surgery regarding Pancreatic cancer? I live in XXXXXXX and we have good pancreatic doctors. And, are there any new treatments? You asked if I was stable, I have had weight loss and loss of appetite. That is why my GI doctor is very concerned.

Answered by Dr. Deepak Sundriyal (10 minutes later)

Brief Answer:
Any pancreatic surgeon can do that

Detailed Answer:
Hello dear.

So a CA 19.9 will be a better test instead of CEA for pancreatic cancer. Of course, if at all turns out to be cancer, it will be difficult to operate and that call will be taken by any expert pancreatic cancer surgeon.

If it is not operable, then it can be shrunk by chemo first, followed by surgery.

You can discuss this with your surgeon. Any expert pancreatic surgeon can do the surgery.

Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (43 minutes later)

Dr XXXXXXX One last question. I had a CT scan in January 2014 that showed no mass around the Celiac Artery. I had an MRI that showed no mass in 2016. How does this mass show up in such little time?

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
Hello. Its unusual but can happen

Detailed Answer:
Hello dear. Yes, i agree that it was not there till 2016 and appeared in a short span, but cancer is notorious for its varied and bizarre presentation and anything can happen. We now have to focus on its optimum management.
Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Deepak Sundriyal (9 hours later)

Dr XXXXXXX I just read on my last CT scan. Stable soft tissue stranding the Celiac Artery. I was under the impression they did not see this tissue, but they did. This is what my GI doctor thinks could be cancer. What does stable soft tissue mean?

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
Hello. It is difficult to judge

Detailed Answer:
Hello dear.

The most common lesion in that area should be a node. But they have written soft tissue. So its difficult to judge actually. May be there are referring to node only. Biopsy will tell the answer for sure.
Thanks and regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Sundriyal (14 hours later)

Dr XXXXXXX I know I have worn out my welcome, but in my relating to your the history of scans, I need to ask another question. I find out today that my CT scan on February 8th did not show any strands around the Celiac Artery, and the pancreas, that included two small stable lesions, was unremarkable. Then my Ct scan did show a small strand around the Celiac Artery on February 24th, and my pancreas was identical to the scan from the 8th. This makes no sense. 16 days for cancer to show up seems improbable. What do you make of this?

Answered by Dr. Deepak Sundriyal (9 hours later)

Brief Answer:
Hello. It is possible

Detailed Answer:
Hello dear.

It is possible as i said earlier that cancer can behave in bizarre way. It is like that in earlier scan the lesion was small enough to be picked by ct, but was present. In the latter scan it grew bigger.

Thanks and regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj