Pancreatic duct stenosis mimicking a tumor due to an aberrant vessel

A case of a 74-year-old man is reported who had liver cirrhosis and a mass lesion in the left liver lobe. The search for a potential primary tumor showed a filiform duct stenosis in the pancreatic head on ERCP. The presumptive diagnosis of a pancreatic tumor with a liver metastasis was made. Due to the poor general condition of the patient no further diagnostic steps were undertaken and he died four weeks later from progressive liver failure. On autopsy an aberrant vessel originating from the superior mesenteric artery (arteria pancreatico-duodenalis dextra superior) was found to cause the ductal stenosis; an hepatocellular carcinoma in the left liver lobe, but no pancreatic tumor was detected.