Pancreatic and Periampullary Cancer

Pancreatic and periampullary tumors include a diverse group of malignant neoplasms that arise in the pancreas or at or near the ampulla of Vater. These neoplasms commonly include adenocarcinomas of the pancreas (pancreatic ductal adenocarcinomas [PDAC]), duodenum, distant common bile duct, or ampulla of Vater in addition to pancreatic neuroendocrine tumors (PNET). Other neoplasms located in this region include intraductal papillary mucinous neoplasms (IPMN), acinar cell cancer, mucinous cystic neoplasms (MCN), and solid pseudopapillary neoplasms (SPN). Presentation of these tumors is often similar given their common location of origin with symptoms including abdominal discomfort, obstructive jaundice and pruritus for lesions located in the head of the pancreas or periampullary region, and pain or abdominal discomfort for pancreatic tail lesions. The surgical management of these neoplasms is often similar given their shared location, but differences in underlying biology can dictate subtle differences in care requiring the need for accurate diagnosis and differentiation of these neoplasms.