Pancreatic CA Flashcards
Where does pancreatic cancer rank among the mortality of CA?
4th
Where does the pancreas sit in the abdomen?
Retroperitoneal space
Which part of the pancreas comprises the majority of the tissue (exo or endocrine)?
Exocrine
What are the stages T1-T4 of pancreatic tumors?
T1 = less than 2 cm T2 = greater than 2 cm T3 = Invades into duodenum, bile duct major veins T4 = invades large arteries, stomach, spleen
What type of tumors arise from the pancreas?
Adenocarcinomas
What is the histology of the adenoCA of the pancreas?
Well differentiated cuboidal cells with duct-like structures that contain mucin
What is the oncogene that is present in the majority of adenoCAs?
KRAS
What are the two oncogenes that are activated in many pancreatic cancers?
Kras and AKT2
What are the three tumor suppressor genes that are mutated in pancreatic cancers?
p16
p53
DPC4
What percent of pts with pancreatic ca have a family h/o it?
7-8%
What are the associated family genetic mutations that are associated with pancreatic CA?
Familial adenomatous polyposis
Peutz-Jegeh
What is the genetic mutation associated with peutz-jeghers syndrome
STK11
Pancreatic cancers are rare below what age?
45 yo
What are the diseases that predispose pts to
DM
Chronic pancreatitis
What are the chemical that predispose pts to pancreatic cancers?
beta-naphthylamine
Benzidine
What is the diet that can predispose to pancreatic cancer?
High in fats and meats
What ethnicity has a higher rate of pancreatic cancer?
Blacks
What is the usual presentation of pancreatic cancer?
Jaundice
weight loss
Abdominal pain
New onset DM I in an older pt is concerning for what?
Pancreatic tumor that obliterate the beta cells
What is the cause of hyperbilirubinemia in pts with pancreatic cancer?
mass effect on common bile duct
Tumors of which part of the pancreas usually present with pain?
Tail or body
How do you diagnose pancreatic tumors?
Imaging (CT especially)
Why are pancreatic cancers particularly deadly?
Not symptomatic until late
What is the best test for determining the resectability of a pancreatic cancer? What determines resectability?
CT
- No extrapancreatic disease
- No extension to the celiac axis or SMA
What happens to the common bile duct and pancreatic duct in pancreatic tumors?
Dilation
What can ERCPs be utilized for?
Detecting small tumors not visualized on CT