Hepatodiaphragmatic interposition of the intestine is a rare anomaly. It was first described by Demetrius Chilaiditi. This disorder may be associated with a variety of disorders. Though it is frequently asymptomatic with incidental radiographic sign Chilaiditi’s syndrome may combine with imperative clinical problems requiring surgical treatment. Some symptoms mimicking the one occurred in pancreatic malignancy which was defined in this report may be the presenting finding in the aged patient with this syndrome. Even though Chilaiditi’s syndrome is not listed among causes of pancreatic cancer, we present the first known report in the literature about the Chilaiditi’s syndrome associated with pancreatic malignancy. [Turk J Cancer 2007;37(3):117-119]