Pancreatic neoplasms
Updates to Article Attributes
Body
was changed:
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
- pancreatic ductal adenocarcinoma ~90-95%
- cystic neoplasm
- intraductal papillary mucinous neoplasm (IPMN)
-
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 tumours
- although the great majority of both benign and malignant pancreatic neoplasms arise from pancreatic epithelial cells, mesenchymal tumours, while rare, can derive from the connective, lymphatic, vascular, and neuronal tissues of the pancreas 7
- they account for 1-2% of all pancreatic tumours and are classified according to their histologic origin 7
- other
Exocrine tumours
- ductal adenocarcinoma is by far the most common primary tumour, usually of the head (65%) and has a very poor prognosis.
-
cystic neoplasms are further divided into
:(with some overlap):- unilocular
- intraductal papillary mucinous neoplasms (IPMN)
-
serous cystadenoma uncommonly uni
/macro locular/macrolocular
- macrocystic
:multilocular- mucinous cystic neoplasm: usually body and tail
- intraductal papillary mucinous neoplasms (IPMN)
- serous cystadenoma uncommonly uni/macrolocular
- microcystic
- serous cystadenoma: usually head. 30% have a central scar
- cystic with a solid component
- macrocystic tumours can have solid component as well
- pancreatic adenocarcinoma may undergo cystic degeneration (8%) 6
- unilocular
- generally solid
See also: cystic pancreatic mass: differential diagnosis
Endocrine tumours
Endocrine tumours of the pancreas are divided into:
-
functional: ~85%
- insulinoma: most common, 10% are malignant
- gastrinoma: second most common, 60% malignant
- glucagonoma: 80% malignant
- VIPoma: 75% malignant
- somatostatinoma: 75% malignant
-
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 tumours
Account for 1-2% of all pancreatic tumours and are classified according to their histologic origin 7:
These are further discussed at pancreatic mesenchymal neoplasms
Classification based on location
Head
- ductal adenocarcinoma
- intraductal papillary mucinous neoplasms (IPMN)
- serous cystadenoma
- pancreatoblastoma (rare and in children)
Body and tail
Intraductal
-<strong>endocrine:</strong> were previously referred 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 <sup>6</sup><ul>- +<strong>endocrine:</strong> 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 <sup>6</sup><ul>
-<strong>cystic neoplasms</strong> are further divided into: (with some overlap)<ul>- +<strong>cystic neoplasms</strong> are further divided into (with some overlap):<ul>
-<a href="/articles/serous-cystadenoma-of-pancreas">serous cystadenoma</a> uncommonly uni/macro locular</li>- +<a href="/articles/serous-cystadenoma-of-pancreas">serous cystadenoma</a> uncommonly uni/macrolocular</li>
-<li>macrocystic: multilocular<ul>- +<li>macrocystic multilocular<ul>
-<strong>generally solid </strong><ul><li><a href="/articles/solid-pseudopapillary-tumour-of-the-pancreas-1">solid-pseudopapillary tumour of pancreas</a></li></ul>- +<strong>generally solid </strong><ul><li><a href="/articles/solid-pseudopapillary-tumour-of-the-pancreas-1">solid pseudopapillary tumour of pancreas</a></li></ul>
-<li><a href="/articles/serous-cystadenoma-of-pancreas">serous cystadenoma</a></li>-<li><a href="/articles/intraductal-papillary-mucinous-neoplasm">intraductal papillary mucinous neoplasms (IPMN)</a></li>- +<li><a href="/articles/intraductal-papillary-mucinous-neoplasm">intraductal papillary mucinous neoplasms (IPMN)</a></li>
- +<li><a href="/articles/serous-cystadenoma-of-pancreas">serous cystadenoma</a></li>
-<li><a href="/articles/pancreatic-intraductal-neoplasia">pancreatic intraductal neoplasia (PanIN)</a></li>- +<li><a href="/articles/pancreatic-intraductal-neoplasia">pancreatic intraductal neoplasia (PanIN)</a></li>
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