Fig. 1

Abdominal CT scans. a The mass is separate from the celiac axis an there is loss of a fat plane between the mass and SMA (white arrow) with less than 90° involvement of its circumference. The first arterial jejunal branch (red arrow) is also encased with tumor. There is also mild narrowing of the medial aspect of the superior mesenteric vein where the tumor abuts around 90° of its circumference. The pancreatic duct is dilated, measuring up to 6 mm. b Following 9 cycles of FOLFIRINOX, the follow up MRI reveals that the head of the pancreas has indistinct margins, but has clearly diminished in size. The measured size is 2.7 × 2.3 mm (prior: 3.9 × 3.2 mm). Pancreatic ductal dilatation has subsided, indicating response to treatment