| Non-Endocrine |
Adenocarcinomas
Most Common
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This is the form of cancer that most people are talking about when they
refer to "cancer of the pancreas." These tumors account for 75% of all pancreas cancers.
Microscopically, adenocarcinomas form glands (collections of cells surrounding an empty
space.) These tumors can grow large enough to invade nerves which can cause back pain.
They also frequently spread (metastasize) to the liver or lymph nodes. If this happens
the tumor may be considered unresectable. |
| The following rare non-endocrine tumors are listed alphabetically. |
Acinar Cell Carcinomas
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These rare cancerous tumors may produce
excess amounts of the digestive enzymes normally produced by the pancreas.This
increase in enzymes causes distinct symptoms in 20% of acninar cell carcinoma
cases. Symptoms may include unusual skin rashes, joint pain and an increased
level of eosinophils, a type of white blood cell.
Microscopically, these tumors have a characteristic grainy appearance. Special tests,
including electron microscopy, can often be used to diagnose this type of tumor. |
Adenosquamous Carcinomas
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This rare variant of pancreatic cancer is similar to adenocarcinoma because it also forms glands. These tumors also show "squamous differentiation." This means that the cells tend to flatten out as they grow.
This variant is important to recognize because it may mimic other types of cancer that often show squamous differentiation. For example, cancer of the esophagus. |
Giant Cell Tumors
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These tumors are extremely rare and
are important to identify because they may not be as aggressive as the
more common adenocarcinomas. As the name indicates, these tumors have unusually
large "giant" cells. This does not mean that the tumor itself
is larger than other types of tumors. |
Intraductal Papillary-Mucinous Neoplasms
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These rare but very distinctive tumors were first described in Japan in the 1980's. The tumors characteristically grow along the ducts of the pancreas that drain
the pancreatic fluid into the small intestine.
Microscopically, they usually appear as finger-like projections (papillae) into the duct.
Some of these tumors are benign and some are malignant (cancerous). Naturally, this
distinction is extremely important to make and can only be determined by a microscopic
examination of the tissue. |
Mucinous Cystadenocarcinomas
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This is a rare, cystic, fluid containing, tumor of the pancreas. The spaces within this spongy tumor are filled with a thick fluid called mucin. Unlike the
serous cystadenomas, these tumors can develop into cancer over time.
These tumors may be benign or fully cancerous. Even in cases where cancer is found the
prognoses for these tumors are better than for the common adenocarcinomas.
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Pancreatoblastomas
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These rare malignant tumors primarily occur in children. The reason for this is unknown. These tumors are referred to as the "pancreatic cancer of infancy."
Microscopically, these tumors appear as nests of flat (squamoid cells)
floating in a sea of more uniform cells. The survival rate for patients
with these tumors is better than for those with adenocarcinomas. |
Serous Cystadenomas
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These rare tumors are usually benign (non-cancerous) growths. They are cystic, fluid containing, tumors with a sponge-like appearance. However, they can grow to be quite large and may need to be surgically removed if symptoms such as pain and weight loss
occur. The vast majority of patients with this type of tumor are cured by its removal.
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Solid and Pseudopapillary Tumors
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These rare tumors occur primarily in women in their 30's. As the name
implies some parts of the tumors are solid and some are papillary. These
benign tumors have a very good prognosis although the tumors can spread so they should be removed
completely.
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| Endocrine |
Endocrine (Islet Cell) Tumors
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These tumors are far less common than the non-endocrine tumors listed above.
They account for about 1% of pancreatic cancers. It is very important that endocrine tumors
be distinguished from non-endocrine because the treatments for the two types are very
different.
The endocrine tumors may produce highly active hormones and therefore have very dramatic symptoms. There are different kinds:
Insulinomas produce large amounts of insulin which can result in
hypoglycemia ( low blood sugar).
Glucagonomas produce glucagon which can result in a very striking skin rash
(necrolytic migratory erythema.)
While most endocrine tumors of the pancreas behave in a benign fashion, it can be very
difficult to predict the behavior of these tumors. A complete list and discussion of
endocrine tumors can be found in the
endocrine section of this web site.
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This site is supported by generous educational grants from
the Vesalius Trust
