Diagnose this unusual case in gastroenterology.
D000230:Adenocarcinoma / Q000175:diagnosis*; D001706:Biopsy; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging; D011859:Radiography