Acute Pancreatitis as a Possible Indicator of Pancreatic Cancer: The Importance of Mass Detection

Abstract

Objective The aims of this study were to assess the incidence of pancreatic cancer and the contributing factors for the diagnosis of tumors in patients with acute pancreatitis and to gain insight into how patients with acute pancreatitis should be followed up. Methods Using the electronic medical database of Shizuoka General Hospital, 177 patients admitted for acute pancreatitis in the past 6 years were evaluated retrospectively for pancreatic cancer. Results Twelve patients (6.8%) were newly diagnosed with pancreatic cancer. During the first hospitalization, 5 patients (41.7%) with a detected pancreatic mass underwent surgical treatment: the final tumor stages were IA, IIA, and IIB in 1, 2, and 2 patients, respectively. In 7 patients (58.3%) without a detected pancreatic mass at the first admission, a pancreatic mass was recognized on follow-up computed tomography (CT) in 2 patients with main pancreatic duct (MPD) dilatation, and 1 patient with recurrent acute pancreatitis. The tumor stages were IA, IIA, and IA, respectively. Among the remaining 4 patients without follow-up, the tumor stage was IV. The patient gender, age, MPD dilatation, tumor marker, and serum amylase level were not significantly associated with pancreatic cancer. The detection of a pancreatic mass on CT led to the diagnosis of pancreatic cancer. Conclusion Acute pancreatitis should be considered as a possible diagnostic indicator of pancreatic cancer. Various factors associated with acute pancreatitis and pancreatic cancer were not predictive of a diagnosis of pancreatic cancer. Only the detection of a pancreatic mass led to the early diagnosis of pancreatic cancer. Patients hospitalized for acute pancreatitis should be followed up with a diagnostic imaging modality.

Acute pancreatitis in patients with pancreatic cancer

“…The rate of AP in PC patients varies widely and has been reported to range from 6.8% to 13.8%. [ 6 , 7 ] Abdominal pain, weight loss, and jaundice were the main symptoms in patients with AP. We observed that abdominal pain occurred in 47 (100%) patients, jaundice in 4 (8.5%), and weight loss in 16 (34.0%).…”

“…They believed that AP recurring after IPMN resection was the result of sudden obstruction of the main duct by abundant mucus secretion. Moreover, Kimura et al [ 6 ] reported that PC may produce some chemical mediators, which may be responsible for AP. However, in our study, not all the cases present with dilatation of main pancreatic duct (6 patients).…”

National Trends and Hospitalizations Related to Pancreatic Cancer in Acute Pancreatitis Patients: A Nationwide Inpatient Sample Study

“…To our knowledge, this is the largest sample of PC in patients with AP using ICD-10 for the year 2016. There has been varied reported incidence of AP in PC patients in the range between 6.8% and 13.8% [17].…”

Pancreatic Cancer Masked by Acute Pancreatitis as well as an Unusual Iatrogenic Complication

“…[1][2][3] The frequency of AP in pancreatic cancer patient has been reported to vary from 6.8% to 13.8% and majority of patients present with mild AP. [4][5][6] The ductal adenocarcinoma causes AP by obstructing the main PD, producing ductal hypertension, and consequent leakage of enzymes. These patients are usually misdiagnosed and the underlying malignancy…”