Retroperitoneal extravasation as the primary symptom of a pancreatic carcinoma

Adenocarcinoma of the pancreas has a low 5-year survival rate of approximately 5%. Early diagnostics of pancreatic carcinoma during early tumor stages is made difficult by the lack of symptoms. In particular, individuals suffering from carcinomas located within the pancreatic tail are at high risk of a missed diagnosis. The early symptoms are usually nonspecific (e.g., nonspecific upper abdominal complaints, decrease in weight, loss of appetite, and impaired performance) and are characteristic only in carcinomas of the pancreatic head with painless icterus. If the patient complains of low back pain, a severe infiltration with no chance of a complete surgical resection is found in most cases. An adenocarcinoma of the pancreatic tail was diagnosed in this case report based on a large retroperitoneal extravasation missing further symptoms. The extravasation found represented a primary infiltration of the left ureter which was not diagnosed in primary computed tomography. © 2007 Springer Medizin Verlag.