Pancreatic Cancer

Pancreatic cancer is malignant tumor arising from the epithelium of pancreatic ducts. Most of them is diagnosed in advanced state and that cause high mortality.

Epidemiology
Pancreatic cancer became a serious problem in western countries and Japan. It is the 2nd commonest gastrointestinal cancer in USA. It is the 4th most common cause of cancer mortality.

Risk factors

 * Male sex
 * Age > 50–70 years
 * Chronic pancreatitis –
 * Alcohol abuse
 * Cigarette smoking
 * Obesity
 * Afroamerican race



Pathology
Pancreatic cancer is adenocarcinoma arising from exocrinous part of pancreas. 90-95% of them is arising from ductal epithelium, 5-10% is acinous. Other histological forms are rare (papillary cystadenocarcinoma, adenosquamous carcinoma or gian cell carcinoma). The most often localization is in the head of pancreas (70%) then in body (20%) and tail (10%).

Clinical features
Symptomatology depends on localization of the tumor. Carcinomas localized in the head of pancreas can very often cause jaundice. It can be the only one early symptom. Tumors localized in the tail can grow very long time and their first symptom can be pain or weight loss.


 * Jaundice – only pancreatic head tumors, which cause biliary obstruction (in 80% pancreatic head tumors).
 * Pain – typically visceral abdominal pain, very often radiating to back (75% patients).
 * Weight loss – caused by anorexia (75% patients), malabsorption is very rare.
 * Courvoisier’s sign - enlarged palpable gallblader, in patients with pancreatic head tumors (<50%).
 * Migratory thrombophlebitis
 * Glucose intolerance

Diagnostic methods

 * lab
 * USG
 * EUSG
 * CT

Related articles

 * Pancreatitis