Pancreatic Cancer Differential Diagnoses

Updated: Sep 11, 2018
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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DDx

Diagnostic Considerations

Pancreatic cancer is notoriously difficult to diagnose in its early stages, when it is a protean disease that can be difficult to distinguish from other, much more common disorders. For example, the National Comprehensive Cancer Network (NCCN) recommends that clinicians consider pancreatic cancer in patients with diabetes who have unusual symptoms such as continuous weight loss and abdominal problems. [2]

Many patients have sought care for symptoms for weeks or months before receiving a definitive diagnosis of pancreatic cancer; in the past, fewer than a third of patients were diagnosed within 2 months of the onset of their symptoms. However, the availability of CT scanning has shortened that interval. Even so, at the time of diagnosis, 52% of all patients with pancreatic cancer have distant disease and 26% have regional spread.

In addition to the differentials listed in the next section, diseases that can mimic the symptoms of pancreatic cancer include the following:

  • Abdominal aortic aneurysm

  • Ampullary carcinoma

  • Intestinal ischemia

  • Gastric lymphoma

  • Pancreatic lymphoma

  • Hepatocellular carcinoma (hepatoma)

  • Bile duct strictures

  • Bile duct tumors

  • Neoplasms of the endocrine pancreas

Differential Diagnoses