Manejo actual del cáncer de páncreas / Current management of pancreatic cancer

El cáncer de páncreas (CP) representa la cuarta causa de muerte por cáncer en países occidentales. En las últimas décadas se han obtenido múlti- ples avances respecto del entendimiento de la biología tumoral, así como en el diagnóstico, tratamiento y paliación del CP; esto demuestra que el abordaje multidisciplinario de dicha patología es esencial. La cirugía representa la mejor opción terapéutica para aquellos pacientes con enferme- dad localizada. Lamentablemente, más del 85% de ellos son diagnosticados cuando el CP se encuentra en estadios avanzados de la enfermedad. El tratamiento adyuvante, especialmente la quimioterapia, ha mejorado significativamente la supervivencia de los pacientes con CP.

Groove pancreatitis vs groove pancreatic adenocarcinoma. Report of two cases and review of the literature / Groove pancreatitis vs groove pancreatic adenocarcinoma. Report of two cases and review of the literature.

Groove pancreatitis (GP) is a rare form of segmental chronic pancreatitis affecting the groove area (anatomic space between the head of the pancreas, the duodenum and the common bile duct). Its clinical and radiological presentation may be similar to groove pancreatic adenocarcinoma (GPA). Nevertheless, treatment and prognosis are totally different. We report two cases of both GP and GPA and review the relevant aspects that may help to clarify the differential diagnosis between these two rare entities. The first patient is a 57-year-old man with a history of chronic alcohol consumption who presented with persistent abdominal pain. The CT-scan findings suggested GP. Due to the persistence of symptoms despite medical treatment, a pancreaticoduodenectomy was performed. Pathologic evaluation confirmed the diagnosis of GP. The second patient is a 72-year-old male who presented with cholestasis and weight loss. The tumor marker CA 19-9 was increased The CT-scan findings were consistent with duodenal dystrophy. In order to rule out malignancy a pancreaticoduodenectomy was performed. Pathologic evaluation revealed a pancreatic head adenocarcinoma (T3-N1-M0). GP is a rare entity that should be suspected in patients with a history of heavy alcohol consumption who complain of chronic abdominal pain and weight loss. Patients without a clear diagnosis even after a through imaging work-up, or those in whom symptoms are persistent in spite of medical therapy, should undergo surgical exploration.