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Metastatic pancreatic carcinoma
Other Resources UpToDate PubMed

Metastatic pancreatic carcinoma

Contributors: Abhijeet Waghray MD, Christine Osborne MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Metastatic pancreatic carcinoma is cancer arising from the pancreas that has spread to a distant location such as the liver, peritoneum, mesentery, mesenteric lymph nodes, and surrounding vasculature. The majority (95%) of malignant pancreatic carcinoma arises from the exocrine pancreas (related to the pancreatic ductal and acinar cells and their stem cells).

Pancreatic cancer is the seventh leading cause of cancer-related deaths in the world, which may be related to the fact that at the time of diagnosis, most pancreatic cancers have already spread outside of the pancreatic parenchyma.

Pancreatic tumors arising from the head and neck of the pancreas (60%-70% of exocrine pancreatic cancers) may spread locally to the celiac axis or the peripancreatic and periportal areas. Pancreatic tumors arising from the tail of the pancreas (20%-25% of exocrine pancreatic cancers) may spread to the common hepatic artery, celiac axis, splenic hilum, or splenic artery. Patients with spread to the mesentery may present with ascites.

The most common presenting symptoms in patients ultimately found to have metastatic pancreatic cancer include generalized weakness (asthenia) and weight loss and anorexia (83%-86%). Abdominal pain is also very common (71%-79%). A little over half of patients will present with jaundice.

Codes

ICD10CM:
C25.9 – Malignant neoplasm of pancreas, unspecified

SNOMEDCT:
314999005 – Metastasis from malignant tumor of pancreas

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

As the signs and symptoms of metastatic pancreatic cancer are very nonspecific, the differential can be extremely broad.

On the differential of fatigue, weight loss, and anorexia:
The differential in the context of new-onset jaundice should include:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:07/15/2020
Last Updated:07/15/2020
Copyright © 2021 VisualDx®. All rights reserved.
Metastatic pancreatic carcinoma
Metastatic pancreatic carcinoma : Abdominal pain, Fatigue, Jaundice, Ascites, Epigastric pain, Anorexia, Cachexia
Imaging Studies image of Metastatic pancreatic carcinoma
Axial image from enhanced CT scan of the abdomen showing a low attenuation mass at the pancreatic tail, (long arrow), consistent with pancreatic cancer with associated multiple low attenuation liver lesions, consistent with metastases, (short arrow).
Copyright © 2021 VisualDx®. All rights reserved.