The Sol Goldman Pancreatic Cancer Research Center

Types of Pancreas Tumors


Non-Endocrine

Adenocarcinomas (most common)
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This is the form of cancer that most people are talking about when they refer to "cancer of the pancreas." These tumors account for >75% of all pancreas cancers.
Microscopically, adenocarcinomas form glands (collections of cells surrounding an empty space.) These tumors can grow large enough to invade nerves which can cause back pain. They also frequently spread (metastasize) to the liver or lymph nodes. If this happens the tumor may be considered unresectable.


The following rare non-endocrine tumors are listed alphabetically.
Acinar Cell Carcinomas
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These rare cancers may produce excess amounts of the digestive enzymes normally produced by the pancreas. This increase in enzymes causes distinct symptoms in 20% of acninar cell carcinoma cases. Symptoms may include unusual skin rashes, joint pain and an increased level of eosinophils, a type of white blood cell.
Microscopically, the cytoplasm of the tumor cells has a characteristic grainy appearance. This is because they contain large amounts of a cell organelle called the zymogen granule. Special tests, including immunohistochemistry, can often be used to diagnose this type of tumor.
Adenosquamous Carcinomas
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This rare variant of pancreatic cancer is similar to adenocarcinoma because it also forms glands. These tumors also show "squamous differentiation." This means that the cells tend to flatten out as they grow.
This variant is important to recognize because it may mimic other types of cancer that often show squamous differentiation. For example, cancer of the esophagus, and because it is associated with a particularly poor prognosis.
Colloid Carcinomas Colloid carcinoma is a distinctive tumor of the pancreas associated with a better prognosis than the more common adenocarcinoma. Under the microscope small nests of tumor cells appear to be "floating" in pools of extracellular mucin. Many colloid carcinomas arise in association with intraductal papillary mucinous neoplasms (IPMNs).
Giant Cell Tumors
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These tumors are extremely rare and are now called "undifferentiated carcinomas with osteoclast-like giant cells". As the name indicates, these tumors have unusually large "giant" cells. This does not mean that the tumor itself is larger than other types of tumors.
Hepatoid Carcinomas
Hepatoid carcinomas have been reported only extremely rarely in the pancreas. Under the microscope, the cells that form this type of cancer look like the cells of a liver cancer. (hepatoid means liver-like)
Intraductal Papillary-Mucinous Neoplasms
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These tumors are also known as "IPMNs". They are important to recognize because they represent a potentially curable precursor lesion to invasive pancreatic cancer. The tumors characteristically grow along the ducts of the pancreas that drain the pancreatic fluid into the small intestine.
Microscopically, they usually appear as finger-like projections (papillae) into the duct. These are believed to start as curable precancerous lesions, and some, if untreated may progress to invasive pancreatic cancer. (FAQs on IPMNs)
Mucinous Cystic Neoplasms
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This is a rare, cystic, fluid containing, tumor of the pancreas. Most are found in the tail of the pancreas in women. The spaces within this spongy tumor are filled with a thick fluid called mucin. Unlike the serous cystadenomas (see below), these tumors can develop into cancer over time.
Pancreatoblastomas
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These rare malignant tumors primarily occur in children. The reason for this is unknown. These tumors are referred to as the "pancreatic cancer of infancy".
Microscopically, these tumors appear as nests of flat (squamoid cells) floating in a sea of more uniform cells. Pancreatoblastomas can also show acinar differentiation and endocrine differentiation.
Serous Cystadenomas
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These rare tumors are usually benign (non-cancerous) growths. They are cystic, fluid containing, tumors with a sponge-like appearance. However, they can grow to be quite large and may need to be surgically removed if symptoms such as pain and weight loss occur. The vast majority of patients with this type of tumor are cured by its removal.
Signet Ring Cell Carcinoma
This rare form of pancreatic cancer has a characteristic microscopic appearance. Signet ring cell carcinomas are composed of infiltrating individual cells with a large mucin vacuole. This mucin vacuole pushes the nucleus to the side, giving the cell a "signet" or ring-like appearance.
Solid and Pseudopapillary Tumors
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These rare tumors occur primarily in women in their 30's. As the name implies some parts of the tumors are solid and some are papillary. These are considered cancers, but they have a very good prognosis. Since they can spread they should be removed completely.
Undifferentiated Carcinomas
Undifferentiated carcinoma is an extremely aggressive form of pancreatic cancer that lacks a direction of differentiation. This means that under the microscope these cancers do not resemble any normal cell type in the body.

Endocrine
Endocrine (Islet Cell) Tumors
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These tumors are far less common than the non-endocrine tumors listed above. They account for about 1% of pancreatic cancers. It is very important that endocrine tumors be distinguished from non-endocrine because the treatments for the two types are very different.
The endocrine tumors may produce highly active hormones and therefore have very dramatic symptoms. There are different kinds:
Insulinomas produce large amounts of insulin which can result in hypoglycemia ( low blood sugar).
Glucagonomas produce glucagon which can result in a very striking skin rash (necrolytic migratory erythema.)
While most endocrine tumors of the pancreas behave in a benign fashion, it can be very difficult to predict the behavior of these tumors. A complete list and discussion of endocrine tumors can be found in the endocrine section of this web site.