Reports of portal vein aneurysm are scattered in the literature. However, with the increased use of sonography, CT, MRI, it is found incidentally with greater frequency. Clinical presentation ranges from without symptom to hemobilia,
hemoperitoneum,
thrombosis, compression of adj acent structures, and spontaneous arteriovenous fistula. Sometimes, it is confused with a pancreatic head mass, raising a diagnostic problem. We report a case of extrahepatic portal vein aneurysm confused with
pancreatic
head cancer. A 45-year-old woman presented with weight loss of 10 ㎏, and ultrasonography and CT revealed a pancreatic head mass. Laparotomy was performed, but resection of the mass was impossible. Later review of the enhanced spiral CT and
angiography
revealed that the mass actually represented a portal vein aneurysm. Her condition has remained stable with just clinical observation. Portal vein aneurysm should be considered when there is an enhancing mass adjacent to the portal vein or
superior
mesenteric vein.
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