Pancreatic neoplasms

Last revised by Dr Henry Knipe on 12 Jul 2022

There are numerous primary pancreatic neoplasms, in part due to the mixed endocrine and exocrine components.

Classification

Classification based on function
  • exocrine: ~99% of all primary pancreatic neoplasms
  • endocrine: were previously referred to as islet cell tumors because they were thought to have originated from the islets of Langerhans, however, new evidence suggests that these tumors originate from pluripotential stem cells in ductal epithelium 6
    • non-syndromic
    • syndromic
  • mesenchymal tumors
    • although the great majority of both benign and malignant pancreatic neoplasms arise from pancreatic epithelial cells, mesenchymal tumors, while rare, can derive from the connective, lymphatic, vascular, and neuronal tissues of the pancreas 7
    • they account for 1-2% of all pancreatic tumors and are classified according to their histologic origin 7
  • other
Exocrine tumors

See also: cystic pancreatic mass: differential diagnosis

Endocrine tumors

Endocrine tumors of the pancreas are divided into:

  • functional: ~85%
  • non-functional: ~15%
    • third most common
    • 85-100% malignant
    • usually larger, as a result of lack of hormonal activity, the clinical presentations are usually delayed till they become large
Mesenchymal tumors

Account for 1-2% of all pancreatic tumors and are classified according to their histologic origin 7. These are further discussed in pancreatic mesenchymal neoplasms.

Classification based on location 
Head
Body and tail
Intraductal

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Cases and figures

  • Figure 1: gross pathology - pancreatic carcinoma
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  • Case 1
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  • Case 2: insulinoma
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  • Case 3: insulinoma
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  • Case 4: islet-cell tumor
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  • Case 5: pancreatic ductal adenocarcinoma
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  • Case 6
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  • Case 7: neuroendocrine tumor and serous cystadenoma
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  • Case 8: metastatic pancreatic adenocarcinoma
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