A 39-year-old female patient was referred to our tertiary oncologic center for additional investigations relating to a suspect pancreatic tail lesion. An abdominal computed tomography scan and magnetic resonance imaging scan showed a solid lesion demonstrating progressive enhancement. Complete resection was obtained and the final diagnosis was that of a desmoid tumor of the pancreas, an exceptionally rare tumor demonstrating overlap with other solid and cystic lesions of the pancreas [1]. Therefore, it is important to recognize the essential role of pathology, particularly immunohistochemistry, in identifying this tumor. The high rate of postsurgical recurrence should prompt repeated follow-ups considering the potential aggressive nature of desmoid tumors.

An elderly woman underwent placement of a pacemaker lead which was complicated by accidental azygos vein cannulation and perforation. However not a very uncommon complication, we report here several findings on CT-angiogram which highlight imaging pitfalls of this entity. We also review how the case was clinically managed.