Vagaries of clinical presentation of pancreatic and biliary tract cancer

Pancreatic and biliary carcinomas remain a challenge to clinicians and inve stigators, as diagnosis is rarely achieved while the tumor is still in a cu rative stage. Clinical symptoms and signs of these neoplasias are non-speci fic and heterogeneous. We review the clinical presentation of these tumors, with an emphasis on th eir pathophysiology and relationship with survival. Abdominal pain is the m ost common presenting complaint in pancreatic and biliary tract carcinomas, regardless of their size; although severe back pain usually indicates neur al compromise, and is associated with a short survival. Jaundice may also b e an early sign in fact, pancreatic tumors that present as painless jaundic e have been adscribed, a relatively mere favorable prognosis. Weight loss i s a common finding in most patients, being usually associated with malabsor ption. These neoplasias may also present as diabetes, as an acute pancreati tis episode, with venous thrombosis or malignant thrombophlebitis, as a gas trointestinal hemorrhage, with mental disturbances, or skin manifestations.