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

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Posted on Fri, 21 Mar 2014
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?
doctor
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
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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