RESUMO
BACKGROUND: Malignant tumors initially presenting with portal vein thrombosis (PVT) are extremely uncommon. METHODS: In this rare case, a 61-year-old male was admitted with pancreatitis-like symptoms and initial imaging manifestations of PVT. The initial abdominal enhanced computed tomography (CT) scan and pathology examination did not show obvious signs of pancreatic cancer. RESULTS: After 3 months, both the enhanced CT scan and intraoperative frozen section examination indicated pancreatic cancer with liver metastasis, while thrombosis was ruled out. Chemotherapy was administered following the operation. CONCLUSIONS: For unexplained PVT, doctors need to be highly vigilant about the possibility of pancreatic malignant tumors to avoid clinical missed diagnosis.