# Pancreatic Tumors — GCMD Library living collection

Experts: Dr. Rod Gerardo, Dr. Jamie Nathan, Dr. David Skarda

Updated: n/a · 2 episodes · 65 cited statements

## Episodes
### Case-Based Learning
- [Pancreatic Masses](https://library.globalcastmd.com/watch/pancreatic-masses-3439) — podcast · 37:28 · [machine version](https://library.globalcastmd.com/watch/pancreatic-masses-3439.md)

### In-Depth Reviews
- [Pancreatic Tumors. Presented by David Skarda, MD 04.10.23 Video](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583) — video · 50:30 · [machine version](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583.md)

## Chapters
- [1:11](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=71) Benign Pancreatic Lesions (Ep 2)
- [5:30](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=330) Solid Pseudopapillary Tumors (Ep 2)
- [20:00](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1200) Malignant Pancreatic Tumors (Ep 2)
- [35:30](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2130) Endocrine Pancreatic Tumors (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=0) Introduction and Differential Diagnosis (Ep 1)
- [5:14](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=314) Common Pediatric Pancreatic Tumors (Ep 1)
- [10:47](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=647) Clinical Presentation and Diagnostic Workup (Ep 1)
- [17:51](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1071) Case Continuation and Diagnostic Dilemma (Ep 1)
- [22:05](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1325) Surgical Approaches to Pancreatic Masses (Ep 1)
- [26:41](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1601) Autoimmune Pancreatitis in Children (Ep 1)
- [34:56](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=2096) Concluding Remarks (Ep 1)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Serous cystadenomas are benign lesions that may grow and become symptomatic, with rare case reports of malignant transformation, and about one-third are identified incidentally" — David Skarda (clinical) [Ep 2 · 2:44](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=164)
- "Serous cystadenomas are cured by removal" — David Skarda (clinical) [Ep 2 · 3:27](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=207)
- "Mucinous cystadenomas are more common in females and the majority are located in the tail of the pancreas" — David Skarda (epidemiological) [Ep 2 · 3:54](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=234)
- "Mucinous cystadenomas are generally considered benign but potentially pre-malignant lesions" — David Skarda (clinical) [Ep 2 · 4:17](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=257)
- "Mature cystic teratomas can arise anywhere within the pancreatic parenchyma and are often adjacent to the pancreas in the retroperitoneum" — David Skarda (clinical) [Ep 2 · 4:51](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=291)
- "Mature cystic teratomas can contain malignancy and are resected based on symptoms and malignant potential" — David Skarda (clinical) [Ep 2 · 5:21](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=321)
- "Solid pseudopapillary tumors are the most common malignant pancreatic tumor in young children, with mean age of 5 years and twice as common in males" — David Skarda (epidemiological) [Ep 2 · 25:55](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1555)
- "Pancreatoblastoma is associated with Beckwith-Wiedemann syndrome and FAP, with some tumors having genetic abnormalities on chromosome 11p15" — David Skarda (clinical) [Ep 2 · 26:10](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1570)
- "In pancreatoblastoma, alpha-fetoprotein is elevated in a fairly high percentage of cases and can be used to monitor for recurrence after resection" — David Skarda (clinical) [Ep 2 · 26:58](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1618)
- "About 60% of gastrinomas are not in the pancreas but in the wall of the duodenum, typically between the common bile duct insertion and the junction of the 2nd and 3rd portion of duodenum" — David Skarda (clinical) [Ep 2 · 47:12](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2832)
- "Solid pseudopapillary tumors occur in young women more than young men, with mean age of diagnosis 28 years" — David Skarda (epidemiological) [Ep 2 · 18:21](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1101)
- "Complete surgical resection with clear margins is the treatment of choice for solid pseudopapillary tumors, and enucleation is not considered adequate treatment" — David Skarda (guideline) [Ep 2 · 18:32](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1112)
- "Overall survival for solid pseudopapillary tumors is really good with complete resection, and lymph node metastases are fairly rare" — David Skarda (clinical) [Ep 2 · 19:08](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1148)
- "Solid pseudopapillary tumors can present with metastatic disease in 15-20% of cases, but survival is still quite good without adjuvant therapy after resecting the primary tumor" — David Skarda (clinical) [Ep 2 · 20:44](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1244)
- "Mucinous cystadenocarcinomas can be challenging to differentiate from mucinous cystadenomas and frequently have foci of dysplastic or frankly malignant epithelium, making sampling problematic" — David Skarda (clinical) [Ep 2 · 31:20](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1880)
- "Acinar cell adenocarcinomas in young children (around 3 years old) tend to be well-circumscribed masses, occur more commonly in males, and can be equally distributed throughout the pancreas" — David Skarda (clinical) [Ep 2 · 32:48](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=1968)
- "Acinar cell adenocarcinomas have much better prognosis than typical ductal adenocarcinoma, and adjuvant chemotherapy or radiation is not necessary after complete resection" — David Skarda (clinical) [Ep 2 · 33:22](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2002)
- "Pancreatic ductal adenocarcinomas in young people are often associated with FAP, Peutz-Jeghers syndrome, or hereditary pancreatic cancer syndrome" — David Skarda (clinical) [Ep 2 · 34:02](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2042)
- "Insulinomas are the most common pancreatic neuroendocrine tumor and are beta islet cell neoplasms that produce excessive insulin leading to hypoglycemia" — David Skarda (clinical) [Ep 2 · 36:12](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2172)
- "Insulinomas tend to be small, relatively well encapsulated, and diagnosed fairly early because they produce insulin" — David Skarda (clinical) [Ep 2 · 36:33](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2193)
- "Whipple's triad for insulinoma diagnosis includes signs and symptoms of hypoglycemia, documented hypoglycemia during the symptomatic period, and resolution of symptoms with glucose administration" — David Skarda (guideline) [Ep 2 · 36:43](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2203)
- "C-peptide levels are checked to ensure hypoglycemia is not from exogenous insulin administration" — David Skarda (clinical) [Ep 2 · 38:57](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2337)
- "Insulinomas tend to be relatively well encapsulated and surprisingly do not have blood vessels attached to them despite being endocrine tumors" — David Skarda (clinical) [Ep 2 · 40:46](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2446)
- "Sporadic insulinomas in children are often isolated and benign, while those with MEN1 tend to be multifocal and have higher incidence of malignancy" — David Skarda (clinical) [Ep 2 · 45:24](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2724)
- "80% of gastrinomas occur sporadically, but 20% occur in the setting of MEN1, with MEN1-associated lesions tending to be multicentric, malignant, and presenting at higher rates of metastasis" — David Skarda (epidemiological) [Ep 2 · 46:38](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2798)
- "Endoscopic ultrasound is really good at finding insulinomas and helps identify the relationship of the mass to the pancreatic duct" — David Skarda (clinical) [Ep 2 · 41:52](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2512)
- "For incidental pancreatic cystic lesions less than 2 centimeters that are difficult to access with biopsy, observation with surveillance imaging is reasonable if they remain stable" (opinion) [Ep 2 · 10:58](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=658)
- "In adults, serous cystadenomas do not require surveillance imaging once diagnosed" (guideline) [Ep 2 · 14:34](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=874)
- "Insulinoma enucleation involves popping the tumor out like a grape, with the main concern being the relationship of the tumor to the pancreatic duct" (clinical) [Ep 2 · 41:09](https://library.globalcastmd.com/watch/pancreatic-tumors-presented-by-david-skarda-md-04-10-23-video-6583?t=2469)
- "Pancreatoblastoma is the most common malignant pancreatic tumor in children, typically presenting in patients less than 10 years of age" — Jamie Nathan (clinical) [Ep 1 · 5:14](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=314)
- "In pancreatoblastoma cases, up to 80% have elevated alpha-fetoprotein" — Jamie Nathan (clinical) [Ep 1 · 5:30](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=330)
- "Up to 45-50% of pancreatoblastoma cases present with metastases" — Jamie Nathan (epidemiological) [Ep 1 · 5:45](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=345)
- "Pancreatoblastomas respond well to cisplatin and doxorubicin-based chemotherapy regimens" — Jamie Nathan (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=360)
- "The number one prognostic factor for pancreatoblastoma is complete surgical excision" — Jamie Nathan (clinical) [Ep 1 · 6:15](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=375)
- "Solid pseudopapillary neoplasms are more common in young female patients in their second or third decade of life" — Jamie Nathan (epidemiological) [Ep 1 · 6:30](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=390)
- "Solid pseudopapillary tumors are indolent and slow growing, often presenting as very large masses" — Jamie Nathan (clinical) [Ep 1 · 6:45](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=405)
- "Enucleation of solid pseudopapillary neoplasms should be avoided due to high recurrence rates" — Jamie Nathan (clinical) [Ep 1 · 6:45](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=405)
- "Solid pseudopapillary lesions have excellent long-term survival with 95% 10-year survival" — Jamie Nathan (clinical) [Ep 1 · 6:45](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=405)
- "Up to 10% recurrence rate has been recorded with solid pseudopapillary neoplasms" — Jamie Nathan (epidemiological) [Ep 1 · 6:45](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=405)
- "Neuroendocrine tumors make up about 1-2% of all pancreatic tumors" — Jamie Nathan (epidemiological) [Ep 1 · 9:09](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=549)
- "Neuroendocrine tumors tend to present in children over 10 years of age but are more common in middle-aged patients" — Jamie Nathan (epidemiological) [Ep 1 · 9:25](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=565)
- "In 10% of patients, neuroendocrine tumors may present in the setting of multiple endocrine neoplasia type 1, von Hippel-Lindau, or tuberous sclerosis" — Jamie Nathan (clinical) [Ep 1 · 9:40](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=580)
- "Insulinoma is the most common neuroendocrine tumor, accounting for almost 50% of pancreatic neuroendocrine tumors" — Jamie Nathan (epidemiological) [Ep 1 · 10:00](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=600)
- "Gastrinomas account for 30% of pancreatic neuroendocrine tumors" — Jamie Nathan (epidemiological) [Ep 1 · 10:15](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=615)
- "Insulinomas are typically benign, with 6% being malignant" — Jamie Nathan (clinical) [Ep 1 · 10:25](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=625)
- "90% of insulinomas are solitary, 10% are associated with MEN1" — Jamie Nathan (epidemiological) [Ep 1 · 10:35](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=635)
- "Insulinomas present with Whipple's triad: symptoms of hypoglycemia, low fasting blood glucose, and symptom resolution with glucose administration" — Jamie Nathan (clinical) [Ep 1 · 10:25](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=625)
- "There is up to about a 10% risk of diabetes after just a distal pancreatectomy in the setting of otherwise normal pancreas" — Jamie Nathan (clinical) [Ep 1 · 22:05](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1325)
- "Autoimmune pancreatitis is more common than pancreatic neoplasms in the pediatric realm" — Jamie Nathan (epidemiological) [Ep 1 · 18:24](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1104)
- "Type 1 autoimmune pancreatitis is IgG4-mediated disease with IgG4 levels elevated in 90% of patients" — Jamie Nathan (clinical) [Ep 1 · 28:53](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1733)
- "Type 1 AIP typically involves IgG4-related systemic disease affecting multiple organs including salivary glands, bile ducts, and retroperitoneum" — Jamie Nathan (clinical) [Ep 1 · 29:20](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1760)
- "Type 2 AIP typically has normal IgG4 levels and is more pancreas-specific" — Jamie Nathan (clinical) [Ep 1 · 29:50](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1790)
- "In 30% of patients with type 2 AIP, the patient may also have inflammatory bowel disease" — Jamie Nathan (epidemiological) [Ep 1 · 30:10](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1810)
- "Over 90% of children with AIP present with abdominal pain" — Jamie Nathan (epidemiological) [Ep 1 · 30:50](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1850)
- "About 40% of children with AIP present with obstructive jaundice" — Jamie Nathan (epidemiological) [Ep 1 · 31:05](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1865)
- "Positive serologies for IgG4 are described in only 22% of pediatric AIP cases in one study" — Jamie Nathan (epidemiological) [Ep 1 · 31:15](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1875)
- "Focal enlargement in the head of the pancreas occurs in about 50% of pediatric AIP patients" — Jamie Nathan (epidemiological) [Ep 1 · 31:30](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1890)
- "Global pancreatic enlargement occurs in 30% of pediatric AIP patients" — Jamie Nathan (epidemiological) [Ep 1 · 31:45](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1905)
- "Main pancreatic duct irregularity is present in about two-thirds of pediatric AIP patients" — Jamie Nathan (epidemiological) [Ep 1 · 31:55](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1915)
- "Common bile duct strictures occur in 55% of pediatric AIP patients" — Jamie Nathan (epidemiological) [Ep 1 · 32:10](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1930)
- "The classic capsule-like rim sign or halo sign around the pancreas is present in only about 16% of pediatric AIP patients" — Jamie Nathan (epidemiological) [Ep 1 · 32:20](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1940)
- "93% of pediatric patients with AIP respond to steroids" — Jamie Nathan (clinical) [Ep 1 · 32:40](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=1960)
- "AIP in children more commonly follows a type 2 presentation rather than type 1 or IgG4-related presentation" — Jamie Nathan (epidemiological) [Ep 1 · 33:30](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=2010)
- "Clinical response to corticosteroid therapy for AIP should be seen within a few weeks" — Jamie Nathan (clinical) [Ep 1 · 34:20](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=2060)
- "Imaging response to corticosteroid therapy for AIP should be anticipated after about three months" — Jamie Nathan (clinical) [Ep 1 · 34:35](https://library.globalcastmd.com/watch/pancreatic-masses-3439?t=2075)

## Changelog
- Aug 31: 3 doctors auto-found from episode dossiers
- Aug 30: 1 doctors auto-found from episode dossiers
- Aug 30: 1 doctors auto-found from episode dossiers
- Aug 29: 1 doctors auto-found from episode dossiers
- Aug 29: 1 doctors auto-found from episode dossiers
- Aug 29: Collection generated from campaign corpus: 2 items, 1 dossiers, summaries for 3 audience(s)
- Aug 29: Collection reviewed and published
- Aug 29: Collection generated from campaign corpus: 1 items, 1 dossiers, summaries for 4 audience(s)

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