Large metastatic lymph nodes misdiagnosed as a pancreatic tumor: a case report

Due to the anatomical proximity between pancreatic tumors and the group 8 lymph nodes of the stomach, misdiagnosis can easily occur. The patient's preoperative examination: computed tomography (CT) scan examination indicated an abdominal mass, 3.0T pancreatic magnetic resonance imaging (MRI) with contrast enhancement showed a pancreatic head lesion, possibly a neuroendocrine tumor. Gastroscopy revealed highly suspicious for cancer. Pancreaticoduodenectomy was planned. However, intraoperative exploration revealed the tumor to be localized within the Group 8 lymph nodes rather than the pancreas. Radical distal gastrectomy, along with resection of the lymph node mass, was performed. Histopathological analysis confirmed early gastric cancer with metastatic lymph node involvement. This case highlights a diagnostic pitfall wherein gastric cancer with lymph node metastasis was mistaken for a pancreatic tumor due to their anatomical overlap.