RADIOLOGY: PANCREAS: Case# 33713: PROBABLE PANCREATIC ADENOCARCINOMA. Patient is a 66-year-old male with abdominal pain, rule out pancreatic lesion. 1. Atrophy with ductal dilatation of the tail of the pancreas and mildly enlarged heterogeneous pancreatic head is worrisome for pancreatic malignancy and ERCP is recommended. There are a few small suprapancreatic lymph nodes and slight soft tissue density around the proximal superior mesenteric artery, also worrisome for tumor extension. No other evidence of metastases.