Carcinoma of the Pancreas

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CARCINOMA of the pancreas does not occur as frequently as do other malignant tumors of the gastrointestinal tract. Lahey1 estimates the incidence between 1 and 2 per cent of all malignant tumors. Between 1928 and 1930, deaths due to carcinoma of the pancreas represented 4.8 per cent of all cancer deaths in the hospitals of the state of Massachusetts (Bigelow2).

The original description of carcinoma of the head of the pancreas by Bard and Pic3 in 1888 was readily accepted, and the classical “progressive painless jaundice” has been associated ever since with the diagnosis. However, this description does not include all the types of carcinoma of the pancreas; Chauffard4 in 1908 described the clinical entity, and his description of the pain still applies.

The clinical manifestations of carcinoma of the pancreas, with the exception of a palpable tumor mass, result from changes in the neighboring organs, such as the common duct, duodenum, and stomach. The whole pancreas forms one physiologic entity. Direct symptoms resulting from possible alteration of the physiology of the pancreas (hyperglycemia) are minimal, as has been recognized by most writers.

Ransom5 in 1935 and Duff6 in 1939 presented excellent reviews of the subject, considering carcinoma of the body and tail as different clinical entities from carcinoma of the head. Ransom reviewed 16 proved cases of carcinoma of the body and tail of the pancreas, while Duff reported 19 cases in which only the body and tail were involved and 3 cases in which the whole gland was. . .



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