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Preoperative pathological biopsy and IHC are indispensable. Misdiagnosis is common if we rely solely on imaging. When we encounter a patient suspected of pancreatic cancer with blood cell abnormalities and no significant increase in carbohydrate antigen 19-9 (CA19-9), we need to be aware of the possibility of pancreatic MS. Preoperative pathological biopsy and IHC are indispensable. Misdiagnosis is common if we rely solely on imaging. In recent years, with the accelerated pace of life, diet, environmental problems occur frequently. Exter
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