Cancer of Pancreas

Cancer of Pancreas

Summarize

Pancreatic cancer is made up of malignant cells in the tissue of the pancreas. The pancreas is a pear-shaped gland about 15 centimeters long. The wider side of the pancreas is called the head, the middle part is called the body, and the narrower side is called the tail. There are many types of pancreatic tumors, some of which are benign (not cancer).

 

        The role of the pancreas in the body:

 

It secretes pancreatic juice into the small intestine to digest and break down food.

Thyroid hormones enter the bloodstream and regulate the levels of sugar and salt in the blood.

 

Epidemiological

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Etiology & Risk Factors

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Classification & Staging

        There are four types of pancreatic cancer in children:

Solid pseudopapillary tumor of the pancreas: the most common type of pancreatic tumor, which is more common in adolescent and young women. The tumor has cystic and solid areas. Solid pseudopapillary tumor of the pancreas rarely metastasizes to other sites and has a good prognosis.

Pancreatic neuroblastoma is common in children under 10 years old. Children with Beckwith-Wiedemann syndrome and familial adenomatous polyposis (FAP) have a higher risk of developing pancreatic neuroblastoma. These tumors can secrete ACTH and ADH. Pancreatic neuroblastoma can metastasize to the liver, lungs, and lymph nodes. The prognosis for pediatric pancreatic neuroblastoma is generally favorable.

Islet cell tumors are rare in childhood and can be either benign or malignant. These tumors are often found in children with type 1 multiple endocrine neoplasia (MEN1). The most common types of islet cell tumors are insulinomas and gastrinomas, which secrete insulin and gastrin, respectively, leading to specific symptoms and signs.

Pancreatic cancer: Pancreatic cancer is extremely rare in children and is divided into two types: acinar cell carcinoma and ductal carcinoma.

 

Clinical Manifestations

Some pancreatic tumors in children are difficult to diagnose early if they do not secrete hormones and cause no symptoms. If the tumor secretes hormones, it can cause corresponding signs and symptoms depending on the type of hormone.

 

        If the tumor secretes insulin, the following symptoms may occur:

Low blood sugar can cause blurred vision, headache, dizziness, fatigue, weakness, tremors, tension, irritability, sweating, confusion or hunger.

 behavior change

 epilepsia

 stupor

 

        If the tumor secretes gastrin, the following symptoms may occur:

Recurring stomach ulcers

Abdominal pain, which may involve the back, can be relieved by taking antacids.

The contents of the stomach flow back into the esophagus

 diarrhoea

 

        Other types of hormones secreted by tumors may also cause the following symptoms:

Water samples show diarrhea

Dehydration (thirst, reduced urine output, dry skin and lips, headache, dizziness or fatigue)

Hypochloremia (confusion, somnolence, muscle weakness and seizures)

Unexplained weight loss or gain

Full moon face and slender limbs

Feeling tired and weak

 hypertension

The skin has purple or pink stretch marks (stretch marks)

        If it is pancreatic head cancer, it may compress the bile duct or obstruct blood flow to the stomach, resulting in the following signs:

Jaundice (yellowing of the skin and whites of the eyes)

Blood in stool or vomit

        If your child has any of these problems, please consult a pediatrician. Other conditions besides pancreatic cancer can cause the same symptoms.

Clinical Department

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Examination & Diagnosis

Diagnosis and staging of pancreatic cancer include:

Physical examination and medical history

Chest X-ray

CT scan

MRI check up

PET scan

 biopsy

        For a description of these inspection methods, see the basic information section above.

 

        Other methods used to diagnose pancreatic cancer are as follows:

 

Endoscopic ultrasound (EUS): The endoscope is a thin tube that enters the body through the mouth or rectum. The endoscope has a light source and a visual lens. The high-frequency ultrasonic probe at the front end of the endoscope emits high-energy ultrasonic waves, making the internal organs echo and form an ultrasonic image.

 

Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure involves X-ray fluoroscopy of the bile ducts from the liver to the gallbladder and from the gallbladder to the small intestine. Pancreatic cancer can cause bile duct stenosis and obstruction, or slow down bile flow, leading to jaundice. The endoscope, a fine tube with a light source, is inserted through the mouth, esophagus, and stomach into the beginning of the small intestine. A catheter, a finer tube, is then inserted into the endoscope to reach the pancreatic and biliary ducts. Contrast agent is injected into the ducts via the catheter for X-ray imaging. If the pancreatic and biliary ducts are obstructed by a tumor, a stent can be placed to relieve the obstruction. During ERCP, tissue samples can also be taken for further examination under a microscope to check for tumor cells.

 

Insulin-like growth factor receptor imaging: Radioisotope scanning is used to detect pancreatic tumors. A small amount of radioactive octreotide (a hormone that binds to carcinoid tissue) is injected intravenously and circulates through the bloodstream. The radioactive octreotide attaches to the tumor, and a special camera that detects radioactivity is used to map the tumor's location in the body. This method is commonly used to diagnose islet cell tumors.

 

Laparoscopy: A type of surgery in which several small incisions are made in the abdominal wall and a laparoscope (a thin tube with a light source) is inserted through one of the incisions. Other instruments can be inserted through this or other incisions to operate on the abdomen, such as removing organs or taking tissue samples for microscopic examination.

 

Open abdominal surgery: surgical operation to cut the abdominal wall, the size of the incision depends on the purpose of the operation. Organs can be removed or tissue samples taken for further microscopic examination.

Clinical Management

For the treatment information below, see the treatment plan overview section above.

 

        Treatment of pancreatic solid pseudopapillary tumors in children may include the following:

The tumor was surgically removed

If the tumor cannot be surgically removed or has metastasized to other parts of the body, chemotherapy is performed.

        Treatment of pediatric pancreatic neuroblastoma may include the following:

The tumor was surgically removed. For pancreatic head cancer, a pancreaticoduodenectomy (Whipple operation) was performed.

Chemotherapy can be used to reduce the volume of the tumor before surgery. If the tumor is too large to be removed after surgery, or if there is distant metastasis, chemotherapy is needed.

Chemotherapy is also needed for tumors that are insensitive to treatment or recurrent.

        Treatment of pediatric islet cell tumors may include symptomatic treatment with drugs that target hormone-secreting tumors, as well as the following:

 

 

 

The tumor was surgically removed

If the tumor cannot be surgically removed or has distant metastasis, chemotherapy and targeted therapy can be performed.

 

        Patients with recurrent pediatric pancreatic cancer may consider participating in clinical trials to test for changes in genes in tumor samples and to target the patient based on the type of gene change.

Prognosis

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Follow-up & Review

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Daily Care

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Cutting-edge therapeutic and clinical Trials

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References

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Audit specialists

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