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Abstract
Primary angiosarcoma of the pancreas is an extremely rare neoplasm that often mimicks
severe acute pancreatitis. A 58-year-old man was admitted with clinical and laboratory
signs of severe acute pancreatitis. Contrast enhanced CT scan demonstrated haemorrhagic
necrotizing inflammation of the pancreas involving the pancreatic tail, splenic hilum
and small bowels with multiple peripancreatic and free abdominal fluid collection.
Percutaneous drainage was performed. After 13 days, laparotomy was indicated because
of persistent intra-abdominal bleeding, fever and a palpable, rapidly growing mass
in the left upper quadrant of the abdomen. During the operation a necrotic, haemorrhagic
mass was found in the pancreatic tail; a frozen section showed malignancy, although
the tumour was unresectable. Despite all conservative and surgical therapeutic attempts,
the patient died within four weeks after diagnosis. Final histology justified primary
angiosarcoma of the pancreas. If a patient with signs of severe acute pancreatitis
has fever without elevated PCT, the presence of a malignant tumour of the pancreas
should be considered.