Pancreatic Head Masses
What is it?
- It is important to distinguish between cancers that originate from different structures, which can present in the pancreatic head giving very similar clinical picture. In the pancreatic head or the peri ampullary region (as near to the ampulla of water in the second part of the duodenum) cancers can originate from the pancreatic tissue, the distal bile duct, the ampullary tissue or the duodenum itself. Each of these cancers may have different behaviour and prognosis despite the similar presentation. Unfortunately it is sometimes difficult to define the origin of the cancer before taking the whole specimen for histological exam.
- is the sixth commonest cancer in the UK. The most common symptoms are jaundice, weight loss, diabetes and back pain. The treatment of choice is surgery, if the tumour presents in an early stage ( before invading the adjacent vessels or giving liver metastasis.
- The most common symptom is jaundice. it tends to present earlier which permits a better chance of surgical treatment.
Distal Bile Duct Cancer
- these are cancers origination from the lower part of the bile duct. They present early with jaundice are likely to be diagnosed in an early stage.
- this rare tumour usually causes a blockage to the exit of the stomach, so it is common to get bloating and vomiting as the initial symptoms. Some patients also get anaemia because of blood loss into the gut.
Other cancers involving the pancreas
- Intraductal papillary mucinous tumors (IPMTs). These are newly diagnosed neoplasams, they originate from the pancreatic ducts and secret mucin. They may present with pain or symptoms of chronic pancreatitis. They are very slow growing cancers, if they are diagnosed in an early stage; they can be removed with a very good long term outcome