Pancreatic Carcinoma

Question 1

Pancreatic carcinoma typical pt

Answer 1

> 70 year old male

Question 2

Pancreatic carcinoma pathology

Answer 2

Mostly ductal adenocarcinoma (metastasize early, present late)
60% arise in head, 25% body, 15% tail

Question 3

Pancreatic carcinoma presentation

Answer 3

Painless obstructive jaundice: jaundice+palpable gallbladder
Anorexia, Weight loss
May present like acute pancreatitis
Hepatomegaly, splenomegaly, lymphadenopathy, ascites

Question 4

Pancreatic carcinoma tests

Answer 4

Increased CA19-9 in blood
US/CT may show mass
ERCP/MRCP identifies mass location

Question 5

Pancreatic carcinoma treatment

Answer 5

Resection (pancreaticoduodenectomy, Whipple’s) if no metastases
Laparoscopic excision if tail lesion

Stent insertion for palliatives care
Opiates/coeliac plexus infiltration with alcohol for pain

Question 6

Pancreatic carcinoma prognosis

Answer 6

Mean survival <6 months

5yr survival 3%, 5-14% with Whipple’s