Pancreatic Cancer – Review

Pancreatic Cancer
1Most common Pancreatic cancer?Pancreatic adenocarcinoma90% of cases
2Most common site of adenocarcinoma in pancreas?Adenocarcinomas commonest site -pancreatic ductal adenocarcinoma (PDAC)arise in Exocrine tissue of the pancreas
3Most common Age of development of Pancreatic adenocarcinoma?Rarely before the age of 40,
>50% cases occur at > 70 years age
4Smokers’ chances of developing the disease return to that of the rest of the populationAfter 20 years [ if they stop smoking]
5Pancreatic neuroendocrine tumors, Called as “PanNETs”arise endocrine tissue of the pancreas
Most common functioning PanNETs Insulinomas and Gastrinomas
6What are the types of pancreatic adenocarcinoma?1. Pancreatic ductal adenocarcinoma – commonest type
2.  Acinar cell carcinoma of the pancreas
3. Cystadenocarcinomas
4. Pancreatoblastoma
5. Pancreatic mucinous cystic neoplasms
Other exocrine cancers include
– adenosquamous carcinomas,
– signet ring cell carcinomas, – – hepatoid carcinomas,
– colloid carcinomas,
– undifferentiated carcinomas,
– undifferentiated carcinomas with osteoclast-like giant cells.
– Solid pseudopapillary tumor
7Trousseau’s syndrome– Portal vein thrombosis
– Deep vein thrombosis
– Superficial vein thrombosis
anywhere on the body – may be associated with pancreatic cancer
Seen in 10% of cases of Pancreatic Cancer
8Commonest Pancreatic metastasis is fromKidney cancer- most common cancer to spread to the pancreas,
followed by
colorectal cancer, skin, breast, and lung cancer
9Hereditary syndromes associated with Pancreatic CancerPeutz–Jeghers syndrome

dysplastic nevus syndrome

autosomal recessive ataxia-telangiectasia

hereditary non-polyposis colon cancer (Lynch syndrome)

familial adenomatous polyposis
PanNETs have been associated with multiple endocrine neoplasia type 1 (MEN1) and von Hippel Lindau syndromes
10Pancreatic serous cystadenomas, Almost always benign
11Types of precancerous lesion1. Intraepithelial neoplasia (PanIN)
2.I ntraductal papillary mucinous neoplasm (IPMN).
3.Pancreatic mucinous cystic neoplasm (MCN)
4.Intraductal tubulopapillary neoplasm
12Most common symptom is unexplained weight lossRegardless of a tumor’s location
13Courvoisier’s sign painlessly swollen gallbladder Raise suspicion, and can help differentiate pancreatic cancer from gallstones
14Most widely used cancer staging system for pancreatic cancerAmerican Joint Committee on Cancer (AJCC) together with the Union for International Cancer Control (UICC).
15Whipple procedure Whipple procedure is the most commonly attempted curative surgical treatment – For cancers involving the head of the pancreas
Pancreatic Cancer

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