- Autosomal dominant polycystic disease
- Congenital cystic lesions of the pancreas
- Cystic fibrosis
- Fibrocystic disease of the pancreas
- Von Hippel-Lindau syndrome
- Solitary pancreatic cysts
Cystic Lesions of the pancreas? (6)
Pancreatic Neoplasms: Adenocarcinoma
Involves the ____ portion of the gland (ductal epithelium)
Most common primary neoplasm of the pancreas and accounts for more than __% of all malignant pancreatic tumors.
Pancreatic Neoplasms: Adenocarcinoma
Pancreatic carcinoma accounts for approx. ___% of all cancer deaths and is the ___ most common cause of cancer-related mortality after lung, breast and colon cancer.
____ is rare before the age of 40; the majority of patients are older than 60.
Prognosis is ___, with a median survival time of 2-3 months and a 1 year survival of only 8%.
Symptoms- depend on the ____ of the tumor; tumors in the pancreatic ___ present symptoms early - cause obstruction of the CBD with subsequent jaundice and hydrops of the gallbladder
Palpable, non-tender gallbladder accompanied by jaundice (Courvoisier Sign) is present in ___% of patients with pancreatic carcinoma.
Symptoms- Tumors in the ___ and ___ of the gland present with less specific symptoms - most common symptoms include weight loss, pain, jaundice, and vomiting as the GI tract becomes invaded by tumor.
Tumors are more frequently ___ in size and tend to ___ the adjacent organs such as the stomach, transverse colon, spleen and adrenal gland.
Cystic Pancreatic Neoplasms:
2 types: ___ adenoma (serous cystadenoma) and ___ adenoma (mucinous cystadenoma/cystadenocarcinoma)
Cystic neoplasms of the pancreas account for less than __-__% of all pancreatic cysts and less than __% of all pancreatic malignancies.
Rare; women; large
Cystic Pancreatic Neoplasms: Microcystic Adenoma (serous cystadenoma)
___, benign disease found more often in ____. Tumor is well circumscribed and usually consists of a ___ mass with multiple tiny cysts.
Cystic Pancreatic Neoplasms: Macrocystic adenoma (mucinous cystadenoma/cystadenocarcinoma
- May be either ____ or ___ with a malignant potential.
- Occurs predominantly in ____
- Usually occurs in the ___ or ___.
- Well-defined cysts contain thick mucinous fluid, internal ___, or mural nodules
Cystic Pancreatic Neoplasms: Macrocystic Adenoma
Clinically nonspecific abdominal symptoms: weight loss, ____ mass, or jaundice are presenting symptoms.
Mucinous cystic neoplasm
Main pancreatic duct
Intraductal Papillary Mucinous Tumor
- Form of ____
- Originates from the ___ or its branches.
- Slow growing lesion affects both ___ and ___ in the 6th&7th decades.
- Histology ranges from ___ to ___
Endocrine Pancreatic Neoplasms
- Arise from ___ cells of the pancreas
- Several types exist
- May be ___ or ___
- Benign adenomas or malignant tumors
- Growth rate is ___
- Usually do not spread beyond the regional lymph nodes and the liver
- Most common functioning islet tumor is ___(60%), followed by ___ (18%).
Endocrine Pancreatic Neoplasms: Insulinomas
- Most are ___, well-encapsulated, with good vascular supply
- Often occur in patients with ____ and ____.
Endocrine Pancreatic Neoplasms: Gastrinomas
- Most are ____
- Are frequently ___ and extrapancreatic
- Are difficult to locate
Endocrine Pancreatic Neoplasms:
- May be ___ or associated with the multiple endocrine neoplasia syndrome type 1 (MEN1)
- MEN1 is characterized by the ___ of parathyroid, pituitary, and pancreatic lesions.
- ___ may be solitary, multiple or diffuse.
- Necrosis, hemorrhage, and calcification are seen more frequently in the ____ malignant type of islet-cell tumors.
Insulinoma (B-Cell Tumor):
- Most common ___ islet cell tumor
- Usually ___
- ___ is found in patients in their 4th-6th decades with hypoglycemic symptoms with immediate relief of symptoms after the administration of intravenous glucose
- Clinical symptoms - palpatations, headache, confusion, pallor, sweating, slurred speech, coma
Gastrinoma (G-Cell Tumor):
- 2nd most common functioning islet cell tumor and produces the ___ syndrome.
- Caused by non-insulin-secreting pancreatic tumors, which secrete excessive amounts of ____
- Stimulates the ___ to secrete great amounts of hydrochloric acid and pepsin, which in turn leads to peptic ulceration of the stomach and small intestine
- Lesions usually affect young adults who have ____ disease
- Carcinoid and multiphormonal tumors
Rare Islet-Cell Tumors? (4)
Rare Islet Cell Tumors:
- Highest incidence of malignancy is found in ___ and ____
- ___ are also associated with gallbladder dilation, fluid-filled distended bowel loops, and excessive secretion of fluid and electrolytes. Thickening of the gastric wall may also be present.
Nonfunctioning Islet-Cell Tumors
- Make up ___% of all islet-cell neoplasms
- Presentation tends to be ___ tumors in the head of the pancreas with a high incidence of ____.
METS to the pancreas:
- Generally, METS to the pancreas is uncommon; reported in __% of patients with cancer.
- Primary tumors that can metastasize to the pancreas include melanomas, breast, GI and lung tumors.
Pancreatic Neoplasms: Lymphoma
- ____ neoplasm
- Most frequently a ____ neoplasm
- Intraabdominal lymphoma may appear as a ____ mass or with necrosis, a cystic mass in the pancreas
- ___ may be displaces anterior instead of posterior, as seen with a primary pancreatic mass
- Multiple nodes are seen along the pancreas, duodenum, porta hepatis, and superior mesenteric vessels.
- Cystic Teratomas
Other retroperitoneal neoplasms? (4)
Parapancreatic Neoplasms: Lymphangiomas
- Most often ___-wall, homogeneous, ___ cysts
- Also have been seen with septa, ___-walls, calcification and ___ debris
Children; young adults
Parapancreatic Neoplasms: Cystic Teratomas
- Found more frequently in ___ and ___.
- Their appearance is a mixed sonographic pattern of cystic, solid, fat and calcifications.