Info

🌱來自: pancreatic cancer

Clinical manifestations of pancreatic cancer

• Painless jaundice (w/ pancreatic head mass), pain radiates to back, ↓ weight & appetite • New-onset atypical DM (25%); migratory thrombophlebitis (Trousseau’s syndrome) • Exam: jaundice, RUQ/epigastric nontender mass, palpable gallbladder (Courvoisier’s sign); hepatomegaly; ascites; L supraclavicular node (Virchow’s) • Laboratory tests may show ↑ bilirubin, ↑ alk phos, anemia

• Sx dependent on location of lesion, painless jaundice, abd pain, anorexia, wt loss, back pain (RP involvement, predictor of unresectable tumor (Surgery 1997;122:53))
• New or worsening DM, acute pancreatitis, or malabsorption (steatorrhea)
• VTE or migratory thrombophlebitis (Trousseau sign)
  • The Trousseau sign of malignancy or Trousseau’s syndrome is a medical sign involving episodes of vessel inflammation due to blood clot (thrombophlebitis) which are recurrent or appearing in different locations over time (thrombophlebitis migrans or migratory thrombophlebitis).
• Exam: Most often nl; jaundice, hepatomegaly, ascites, abd mass, left supraclavicular LAD (Virchow node), periumbilical LAD (Sister Mary Joseph nodes)
• Labs: Hyperglycemia, ↑ AST/ALT, ↑ conjugated bili., ↑ amylase/lipase, anemia, prolonged PT/INR due to malabsorption of fat-soluble vitamins