Pancreatic tumors

1. Big picture

For the final exam, pancreatic tumors mainly means pancreatic ductal adenocarcinoma until proven otherwise. It is aggressive, often diagnosed late, and classically presents with:

Weight loss + painless progressive jaundice + dark urine/pale stool + pruritus → think pancreatic head carcinoma.

The examiner usually wants you to recognize:

1. Pancreatic head tumor → obstructive jaundice, Courvoisier sign.
2. Body/tail tumor → late vague epigastric/back pain, weight loss, metastases.
3. CA 19-9 is not a screening or diagnostic test; it is mainly for follow-up.
4. Contrast-enhanced pancreas-protocol CT is the key staging test.
5. **Surgery is the only