Pancreatic Cancer Test Questions – Flashcards

-Often diagnosed late -Over 80% of tumours are adenocarcinomas that occur at the head of the pancreas -Metatasises early, present late - 25% body, 10% tail, endocrine tumours are rare

1. Increased age 2. Smoking 3. Diabetes 4. Chronic pancreatitis 5. Hereditary non-polyposis colorectal carcinoma 6. Multiple endocrine neoplasia 7. BRCA2 gene

-Classically painless jaundice -However patients present in a non-specific way with anorexia, weight loss, epigastric pain -Loss of endocrine function (steatorrhoea) -Atypical back pain is seen -Migratory thrombophlebitis (Trosseaus sign) is more common than with other cancers Also -Palpable gallbladder -Ascites -Splenomegaly (PV thrombosis -> portal HTN)

he Trousseau sign of malignancy or Trousseau's syndrome is a medical sign involving episodes of vessel inflammation due to blood clot (thrombophlebitis) which are recurrent or appearing in different locations over time (thrombophlebitis migrans or migratory thrombophlebitis). The location of the clot is tender and the clot can be felt as a nodule under the skin. Trousseau's syndrome is a rare variant of venous thromboembolism (VTE) that is characterized by recurrent, migratory thrombosis in superficial veins and in uncommon sites, such as the chest wall and arms. This syndrome is particularly associated with pancreatic, gastric and lung cancer and Trousseau's syndrome can be an early sign of cancer

-Bloods: cholestatic LFTs, increased Ca19-9, increased calcium - US - sensitivity of around 60-90% -High resolution CT scanning is the investigation of choice if the diagnosis is suspected -ERCP shows anatomy and allows stenting

*Surgery* -If fit, no mets, tumour