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What is Pancreatic carcinoma most common variety is: and explain in detail?
Ans: a (Adenocarcinoma) Ref: Bailey & Love, 24th ed, p. 1128More than 85% of pancreatic carcinoma are duct cell adenocarcinoma.Prolonged natural history - CystadenocarcinomaIncreased survival after resection - Ampullary tumour, neuroendocrine tumourStart as a benign tumour and progress after years into an aggressive malignant lesionMen and women have equal occurrence.}- Intraductal, papillary mucous secreting tumour.Neoplasms of pancreas are of two types1. Those arising from endocrine pancreas i.e., islet cells2. Those arising from exocrine pancreas i.e., ducts and aciniFunctional pancreatic endocrine tumours* Insulinoma - From 6 cells (produce insulin & symptoms of hypoglycemia)* Gastrinoma - From G cells (produce gastrin & Zollinger Ellison syndrome)* Glucagonoma - Arise from a cells & produce glycogen & hyperglycaemia* Somatostatinoma - Arise trom a or D cells* VIPoma* GRFomas & many othersBRIDGEPassaro's triangle - about 70-90% of gastrinoma are located within this triangle 3 points making the Passaro's triangle:- Junction of cystic duct and CBD- Junction of 2nd and 3rd portion of duodenum- Junction of neck and body of pancreasWhipple triad (Insulinoma)* Signs & symptoms of hypoglycaemia during fasting* Relief of symptoms by intravenous administration of glucose* Blood glucose below 2.8 mmol/1 (50 mg/dl) during symptomatic episodesTreatment of Ca head of pancreasWhipple resection