Considerations on early diagnosis of carcinoma of the pancreas.
OBJECTIVE
Pancreas carcinoma is seldom recognized at an early stage. Through an attentive retrospective evaluation of the patient's history a frequent pattern of early presentation is sought.


METHODS
A series of 64 patients (36 males; 28 females) with histologically proven pancreas carcinoma seen in the Department of Surgery and the Oncology Department of the University of Milan (Ospedale "L. Sacco") in the years 1992 through 2001, is closely scrutinized, tracing the very initial signs and symptoms in each individual case.


RESULTS
Weight loss is by far the most frequent early complaint, being the presenting symptom in more than 79% of cases, either alone or associated with one or more additional symptoms, followed by pain (56%), anorexia (28%), jaundice (25%) and asthenia (23%). However it appears that weight loss is often overlooked until other more suggestive symptoms ensue. In particular, slowly developing jaundice was the most common indication for ultrasound scan or computed tomography study, although jaundice was the presenting symptom in only 25% of cases.


CONCLUSIONS
In patients presenting with unexplained weight loss, a more liberal use of diagnostic imaging techniques in the upper abdomen might be advisable.
Elli
Marco
M
Università degli Studi di Milano Ospedale Luigi Sacco, via G.B. Grassi, 72, 20157 Milano, Italy. Marco.Elli@unimi.it
Piazza
Elena
E
Franzone
Paola Colli
PC
Isabella
Luigi
L
Poliziani
Dario
D
Taschieri
Angelo M
AM
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000855:Anorexia / Q000209:etiology; D001247:Asthenia / Q000209:etiology; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D015431:Weight Loss