Pancreatic cancer classification: Difference between revisions

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Revision as of 13:48, 14 November 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Pancreatic cancer can be classified into malignant and borderline malignant. Duct cell carcinoma is the most common type of pancreatic cancer.

Duct cell carcinoma (90% of all cases)
Acinar cell carcinoma
Adenosquamous carcinoma
Cystadenocarcinoma (serous and mucinous types)
Giant cell carcinoma
Invasive adenocarcinoma associated with cystic mucinous neoplasm or intraductal papillary mucinous neoplasm
Mixed type (ductal-endocrine or acinar-endocrine)
Mucinous carcinoma
Pancreatoblastoma
Papillary-cystic neoplasm (Frantz tumor). This tumor has lower malignant potential and may be cured with surgery alone
Papillary mucinous carcinoma
Signet ring carcinoma
Small cell carcinoma
Unclassified
Undifferentiated carcinoma


Types of Pancreatic Cancers
Pancreatic Exocrine Cancers
Adenocarcinoma
Acinar cell carcinoma
Adenosquamous carcinoma
Giant cell tumour
Intraductal papillary mucinous neoplasm (IPMN)
Mucinous cystadenocarcinoma
Pancreatoblastoma
Serous cystadenocarcinoma
Solid and pseudopapillary tumours
Pancreatic Endocrine Cancers (Pancreatic Neuroendocrine Tumours)
Gastrinoma
Glucagonoma
Insulinoma
Nonfunctional islet cell tumour
Somatostatinoma
Vasoactive intestinal peptide releasing tumour (VIPoma)

Functional Pancreatic Neuroendocrine Tumors and their Characteristics are mentioned in the following table:^[3]


Functional Pancreatic Neuroendocrine Tumors and their Characteristics
Tumor type and syndrome	Location in pancreas	Signs and symptoms	Circulating biomarkers
Insulinoma (Whipple’s triad)	Head, body, tail (evenly distributed)	Hypoglycemia, dizziness, sweating, tachycardia, tremulousness, confusion, seizure	CgA and CgB, insulin inappropriate for blood glucose level, proinsulin, C-peptide
Gastrinoma (Zollinger–Ellison)	Gastrinoma triangle Often extrapancreatic (duodenal); can be found anywhere in gland	Gastric acid hypersecretion, peptic ulcer, diarrhea, esophagitis, epigastric pain	CgA, gastrin, PP (35%)
VIPoma (Verner– Morrison syndrome, WDHA)	Distal pancreas (body and tail) Often spread outside pancreas	Watery diarrhea, hypokalemia, achlorhydria (or acidosis)	CgA, VIP
Glucagonoma	Body and tail of pancreas Often large and spread outside pancreas	Diabetes (hyperglycemia), necrolytic migratory erythema, stomatitis, glossitis, angular cheilitis	CgA, glucagon, glycentin
Somatostatinoma	Pancreatoduodenal groove, ampullary, periampullary	Gallstones, diabetes (hyperglycemia), steatorrhea	CgA, somatostatin
Ppoma	Head of pancreas	None	CgA, PP

↑ National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publiciation/pdq
↑ Bond-Smith G, Banga N, Hammond TM, Imber CJ (2012). "Pancreatic adenocarcinoma". BMJ. 344: e2476. doi:10.1136/bmj.e2476. PMID 22592847.
↑ Ryan DP, Hong TS, Bardeesy N (2014). "Pancreatic adenocarcinoma". N Engl J Med. 371 (11): 1039–49. doi:10.1056/NEJMra1404198. PMID 25207767.

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-*Functional Pancreatic Neuroendocrine Tumors and their Characteristics are mentioned in the following table:<ref name="pmid25207767">{{cite journal| author=Ryan DP, Hong TS, Bardeesy N| title=Pancreatic adenocarcinoma. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 11 | pages= 1039-49 | pmid=25207767 | doi=10.1056/NEJMra1404198 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25207767  }} </ref>
+*'''Functional Pancreatic Neuroendocrine Tumors and their Characteristics are mentioned in the following table:'''<ref name="pmid25207767">{{cite journal| author=Ryan DP, Hong TS, Bardeesy N| title=Pancreatic adenocarcinoma. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 11 | pages= 1039-49 | pmid=25207767 | doi=10.1056/NEJMra1404198 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25207767  }} </ref>
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