Pancreatic cancer


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Pancreatic cancer


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Gastrointestinal system pathology review

Congenital gastrointestinal disorders: Pathology review

Esophageal disorders: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Inflammatory bowel disease: Pathology review

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Colorectal polyps and cancer: Pathology review

Neuroendocrine tumors of the gastrointestinal system: Pathology review

Pancreatitis: Pathology review

Gallbladder disorders: Pathology review

Jaundice: Pathology review

Viral hepatitis: Pathology review

Cirrhosis: Pathology review


Pancreatic cancer


0 / 9 complete

USMLE® Step 1 questions

0 / 1 complete

High Yield Notes

18 pages


Pancreatic cancer

of complete


USMLE® Step 1 style questions USMLE

of complete

A 57-year-old man comes to his primary care physician for evaluation of abdominal pain and fatigue. His symptoms began 4 months ago and have progressively worsened. In addition, he reports a 5 kg (11 lb) unintentional weight loss since symptom onset. The patient often wakes up at night drenched in sweat. Past medical history is notable for peripheral vascular disease and alcohol use disorder. The patient has a 40-pack-year smoking history. Physical examination shows jaundice and scleral icterus. Abdominal pain is most prominent in the epigastric region. Laboratory testing reveals the following findings:  
Laboratory value  Result
 Total bilirubin  5.2 mg/dL 
 Conjugated bilirubin  4.6 mg/dL 
 Alkaline phosphatase  96 U/L 
 Aspartate transaminase  110 U/L 
 Alanine transaminase  112 U/L 
 Lipase*  95 U/L 
*Normal range: 12-70 U/L   

Which of the following additional findings will be most likely present on this patient’s physical examination?  

External References

First Aid








Abdominal pain

pancreatic cancer p. 406


pancreatic adenocarcinoma p. 407


pancreatic cancer p. 406

Courvoisier sign

pancreatic cancer p. 406

Diabetes mellitus p. 352-360

pancreatic cancer p. 404

Jaundice p. 402

pancreatic cancer p. 404

Pancreatic cancer p. 404

5-fluorouracil for p. 448

adenocarcinomas p. 406

biliary cirrhosis and p. 404

carcinogens causing p. 223

hyperbilirubinemia with p. 402

metastases of p. 224

oncogenes and p. 222

paraneoplastic syndromes with p. 221

presentation p. 717

tumor suppressor genes and p. 222

Radiation therapy

pancreatic cancer p. 406


pancreatic cancer and p. 406


pancreatic cancer p. 406

Trousseau syndrome

pancreatic cancer p. 406

Weight loss

pancreatic cancer p. 406

Whipple procedure

for pancreatic cancer p. 406


Content Reviewers

Rishi Desai, MD, MPH


Tanner Marshall, MS

Pancreatic carcinoma describes the pancreas having cancerous cells arise.

Now a healthy pancreas has two types of glands, exocrine glands which sends digestive enzymes off to the small intestine, and endocrine glands which help regulate metabolism in the body, for example, maintaining normal blood sugar.

Over 95% of pancreatic tumors develop in the pancreas’s exocrine tissues, and of these, tumors arising in the epithelial cells lining the pancreatic ducts account for the vast majority of cases.

This type of pancreatic cancer is known as pancreatic adenocarcinoma due to the cells glandular-like (“adeno”) appearance under the microscope, often pancreatic adenocarcinoma is used interchangeably with pancreatic carcinoma.

These tumors typically form in the head or neck of the pancreas, but in some cases tumors form in the tail.

Around 5% of exocrine pancreatic carcinomas are caused by malignancies in the acinar cells, which are the cells that produce the digestive enzymes like trypsinogen, and around 1% are cystadenocarcinomas, or malignant cysts.

There are also other types of pancreatic cancer, but those are even more rare.

Generally, pancreatic carcinoma is caused by genetic mutations in the ductal epithelial cells, and these mutations might activate oncogenes which promote cancer or inactivate tumor suppressor genes.

Either way, this can lead to uncontrolled cell growth caused by the disruptions of the cell signalling pathways that regulate cell survival and growth, as well as multiple immune system responses like inflammation and stress responses.

Although it’s not exactly clear how the genetic mutations that trigger pancreatic carcinoma develop, there are some well known modifiable risk factors like smoking which increases the risk by two to five-fold, obesity, as well as eating a diet high in red meat.


Pancreatic cancer is an aggressive tumor arising from the pancreatic duct mostly of the head or neck. The most common type of pancreatic cancer is pancreatic adenocarcinoma. Symptoms of pancreatic cancer can include abdominal pain radiating to the back, weight loss, jaundice, loss of appetite, nausea, and fatigue.

Pancreatic cancer is caused by genetic mutations in the ductal epithelial cells, which activate oncogenes that promote cancer or inactivate tumor suppressor genes. The risk factors include smoking, a family history of pancreatic cancer, and certain medical conditions such as diabetes and pancreatitis. Treatment for pancreatic cancer may include surgery, chemotherapy, or radiotherapy, depending on the stage of cancer and the patient's overall health.


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