Abstract
Pancreatic cancer (PC) is 1 of the deadliest cancers, representing the fourth leading cause of cancer death in the world; This high mortality is due to late symptom onset and because most of the cases of pancreatic cancer are stage IV at diagnosis, and hence not a candidate for curative resection. The following report will serve to emphasize the role of new-onset diabetes in certain patients as a warning sign necessitating further investigation for pancreatic cancer. It’ s about a 46-years old man was admitted in hospital «service of forensic and penitentiary medicine » for jaundice associated with progressive asthenia, abdominal pain, and weight loss. He had been diagnosed with diabetes 4 weeks earlier by his GP. Despite lifestyle changes, he had been commenced on metformin after just 2 weeks due to poor glycaemic control. Physical examination showed a mass of the upper right quadrant on palpation. Computed tomography of the abdomen showing a solid mass of 55 mm in the head of the pancreas, hypodense in particular, with mild Wirsung and bile ducts dilatation, and the focal thrombi is found at the level of the 9 mm splenomersaraic confluent, with hepatic secondary localization images. He was subsequently diagnosed with new-onset diabetes and metastatic pancreatic cancer. The treatment with basal insulin / bolus and anticoagulant therapy was instituted and after stabilization; the patient has been oriented for bilio-pancreatic derivation, and eventual biopsy in a specialized center, but unfortunately the patient died only a few weeks after. PC occurs with increased frequency in patients with type 2 diabetes mellitus (DM2) which is considered the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Although numerous studies have linked both entities since 1833 the mechanism behind this association are complex and not well understood by the moment.
Highlights
Pancreatic cancer is one of the most common cancers world-wide, with a 5-year survival rate of approximately [7%-8%], and for most patients, death occurs within 6 months after the diagnosis [1,2,3,4].Despite decades of effort, there are still few early detection methods or effective treatments, and at diagnosis, most patients have locally advanced unresectable or metastatic lesions, rendering them Incurable, [5] PC is expected to become the second leading cause of cancer mortality by 2020[2]
Nassima Dekdouk et al.: Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review association was supported by statistically significant relative risk near to 2 in several studies [11]
It is well understood that while long-standing diabetes is an etiologic factor for pancreatic cancer, new-onset diabetes can be a manifestation of the cancer [12]
Summary
Pancreatic cancer is one of the most common cancers world-wide, with a 5-year survival rate of approximately [7%-8%], and for most patients, death occurs within 6 months after the diagnosis [1,2,3,4]. Type 2 diabetes mellitus is likely the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity [2, 8,9,10]. The association between diabetes mellitus (DM) and pancreatic cancer has been known for over a century; This. Nassima Dekdouk et al.: Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review association was supported by statistically significant relative risk near to 2 in several studies [11]. It is well understood that while long-standing diabetes is an etiologic factor for pancreatic cancer, new-onset diabetes can be a manifestation of the cancer [12]
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