Pancreatic carcinoma C25.9

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 31.12.2022

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Synonym(s)

Pancreatic cancer

Definition
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Pancreatic carcinoma, also known as pancreatic cancer, refers to a carcinoma in the exocrine part of the pancreas.

Occurrence/Epidemiology
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Pancreatic carcinoma occurs annually in an average of 15 per 100,000 inhabitants and is the third most common tumour of the digestive tract. The mean age of the disease is 68 to 76 years (m=70J; w=76J).

Etiopathogenesis
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The exact cause of pancreatic cancer is not known. However, risk factors such as genetic predisposition (see below Pancreatic cancer, familial), the consumption of cigarettes and alcohol, obesity, chronic pancreatitis, and cystic neoplasms of the pancreas play a role.
A familial predisposition is present if there are:

2 relatives 1st degree

3 relatives 3rd degree

1 relative with pancreatic carcinoma before the age of 50.

are present.

Clinical features
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There are no early symptoms of pancreatic carcinoma, so in many cases the diagnosis is made late. The symptoms are similar to those of chronic pancreatitis: at the beginning there is often back pain, in addition to nausea, loss of appetite and weight, non-specific pain in the upper abdomen and accompanying pancreatitis. In the context of pancreatic head carcinoma, an icterus can be the first symptom.
Other, less common symptoms of pancreatic carcinoma are thrombophlebitis migrans and a general tendency to thrombosis, pathological glucose intolerance or diabetes mellitus, panniculitis associated with eosinophilia and polyarthritis.

Diagnosis
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The diagnostic procedure for pancreatic cancer includes sonography and endosonography, "one-stop-shop" mrt, spiral and angio CT and ERCP. Additional examinations include PET with FDG, cytology of the pancreatic secretion, celiacography, determination of the tumour markers CA 19-9 and CA 50 and molecular genetic diagnostics.

Differential diagnosis
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The differential diagnosis is chronic pancreatitis and an icterus of a different genesis.

Therapy
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Treatment of pancreatic cancer includes R0 resection with lymphadenectomy, adjuvant chemotherapy, neoadjuvant radiochemotherapy and palliative therapy for metastases and inoperability.

Progression/forecast
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Pancreatic carcinoma can only be completely resected in about 15% of cases. 5-year survival rate: up to 40%, provided that the pancreatic carcinoma does not exceed 2 cm in diameter and has not metastasized. If the lymph nodes are affected, the prognosis decreases.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 31.12.2022