Case Report: Metastatic pancreatic ductal adenocarcinoma initially masked by multiple gastroduodenal ulcers with apparent endoscopic healing: a diagnostic pitfall - Report - MDSpire
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Case Report: Metastatic pancreatic ductal adenocarcinoma initially masked by multiple gastroduodenal ulcers with apparent endoscopic healing: a diagnostic pitfall
Pancreatic ductal adenocarcinoma (PDAC) is often diagnosed at an advanced stage due to nonspecific early symptoms that can mimic benign gastrointestinal disorders. This case illustrates the diagnostic challenges posed by multifocal gastroduodenal ulcers that may obscure underlying malignancies.
Data Highlights
No numerical data or trial data available in the source material.
Key Findings
A 69-year-old man presented with intermittent epigastric discomfort and multiple gastroduodenal ulcers.
Initial biopsies showed only chronic inflammatory changes without dysplasia or malignancy.
Despite treatment with high-dose vonoprazan and apparent endoscopic healing, the etiology of the ulcers remained unexplained.
Progressively rising CA19-9 levels prompted further imaging, revealing a pancreatic tail mass with hepatic and peritoneal metastases.
Laparoscopic biopsy confirmed moderately differentiated adenocarcinoma of pancreatic origin.
Clinical Implications
This case underscores the importance of considering underlying malignancies in patients with unexplained multifocal ulcerative disease, even when endoscopic healing is observed. Clinicians should remain vigilant for persistent symptoms and laboratory abnormalities that may warrant further imaging.
Conclusion
The case highlights that apparent endoscopic resolution of gastroduodenal ulcers does not rule out serious underlying conditions such as metastatic PDAC.
