Question: A 24-year-old woman presented with epigastric pain which began about 2 years ago and progressively worsened over the past 6 months. The pain occurred intermittently but usually began after a meal, lasted for about 1 hour, and radiated to the back. The patient said that she also had lost 4 kg during the past 3 months. Her past medical history was unremarkable and physical examination was positive only for mild epigastric tenderness. Laboratory test results at admission were as follows: amylase, 208 U/L; lipase, 261 U/L; total serum bilirubin, 0.48 mg/dL; direct serum bilirubin, 0.1 mg/dL; aspartate transaminase, 14 IU/L; alanine transaminase, 6 IU/L; alkaline phosphatase, 49IU/L; γ-glutamyl transferase, 12 IU/L; carbohydrate antigen 19-9, 7.7 IU/mL; α-fetoprotein, 1.0 ng/mL; carcinoembryonic antigen, 1.0 ng/mL; and cancer antigen 125, 7.1 U/mL.