12th May 2024

A 67-year-old man presents with persistent nausea, vomiting, and a recent onset of melena.

A 67-year-old man presents with persistent nausea, vomiting, and a recent onset of melena. He reports a loss of appetite and a 10-kg weight loss over the past 3 months. His medical history is notable for chronic atrophic gastritis and a high-salt diet. Gastroscopy reveals a large, irregular mass in the body of the stomach, and a biopsy confirms poorly differentiated adenocarcinoma. CT imaging indicates local invasion of the pancreas but no evidence of distant metastases.

Which is the most likely route by which this tumour spread to the pancreas?