Flashcards in 75. Pancreatic adenocarcinoma Deck (18)
origin / histology
arising form pancreatic ducts
histology: disorganized glandular structure with cellular infiltration
prognosis ( why)
average survival 1 year after diagnosis --> very aggressive , often metastatic at presentation
2. chronic pancreatitis ( esp >20 years
4. >50 age
5. Jewish and African american males
1. abdominal pain radiating to back
2. weight loss ( malabsoroption and anorexia )
3. migratory thromboplenitis ( trousseau syndrome)
4. obstructive jaundice ( and pale stool) with Courvoisier sign ( if at head)
5. secondary DM ( if at body or tail)
Trousseau syndrmoe ? ( and frequency )
Migratory thrombophlebitis --> redness and tenderness on palpation of extremities ( seen in 10%)
presence of a palpably enlarged gallbladder which is nontender and accompanied with mild painless jaundice, the cause is unlikely to be gallstones
1. Whipple procedure ( en bloc removal of the head and neck of pancreas, proximal duodenum, gallabladder)
3. radiation therapy
1. CA 19-9
2. CEA ( not specific)
CEA as a marker
1. colocrecta ca (70%)
2. pancreatic ca (70%)
3. gastric ca
4. breast ca
5. medullary thyroid ca
• You diagnose a woman with pancreatic adenocarcinoma and she immediately asks about the prognosis. How do you respond?
The prognosis is poor—average survival is ~1 year after diagnosis, as it has typically already metastasized at the time of diagnosis
• A patient presents with weight loss, night sweats, and painless jaundice. Where is the tumor most likely located?
The pancreatic head (jaundice with a nontender, palpable gallbladder is the Courvoisier sign, associated with pancreatic adenocarcinoma)
• A mass is found on the head of the pancreas of a patient. What abnormal lab findings would be expected?
Increased alkaline phosphatase and bilirubin levels, indicating obstructive jaundice
• Obstructive jaundice with a palpable, nontender gallbladder on abdominal exam is known as what?
Courvoisier sign (associated with pancreatic adenocarcinoma, but also possibly due to other acute distal bile duct obstructions)
• You find redness and tenderness on palpation of the extremities in a patient with pancreatic adenocarcinoma. What is this sign called?
Trousseau syndrome, or migratory thrombophlebitis
• What two ethnic groups have an increased risk for pancreatic cancer?
Jewish and African-American male groups
• Which two tumor markers are commonly associated with pancreatic cancer? Which is more specific for the disease?
CA 19-9 (more specific) and carcinoembryonic antigen (CEA is less specific)
• Which is most likely to be a risk factor for pancreatic cancer: alcohol, cigarettes, or sulfa drugs?