Pancreatic tumor

What is a pancreatic tumor?

A pancreatic tumor is any abnormal growth inside the pancreas, an organ that does two main jobs: it makes juices that digest food and produces hormones (like insulin) that control your blood sugar. Because these tumors start in different types of cells, they behave very differently from one another.

The main types include:

Digestion-cell tumors (exocrine): these are the most common and start in the cells that create digestive juices.

• Pancreatic ductal adenocarcinoma (PDAC): The most common type, accounting for the large majority of pancreatic cancers. It is highly aggressive and critical to catch early.

• Acinar cell carcinoma: a very rare type (only 1% of cases) that specifically attacks the enzyme-making cells.

• Solid pseudopapillary neoplasm (SPN): a rare, slow-growing tumor found mostly in young women that has an excellent cure rate with surgery.

Hormone-cell tumors (neuroendocrine): These rare tumors start in your hormone-producing cells. They grow much slower than exocrine tumors and are grouped by whether they actively pump out extra hormones:

• Pancreatic neuroendocrine tumors (PNETs): rare hormone-cell tumors that vary wildly in behavior, ranging from small, slow-growing growths with excellent outcomes to aggressive cancers. Many PNETs can be identified and characterised on MRI, although their appearance varies depending on tumour type and size.

• Functioning PNETs: active tumors that flood your body with excess hormones, causing unique medical issues like dangerously low blood sugar (insulinoma), severe stomach ulcers (gastrinoma), skin rashes (glucagonoma), or watery diarrhea (VIPoma).

• Non-functioning PNETs: inactive tumors that do not produce any hormones. They usually grow silently without symptoms and are typically discovered incidentally during a regular imaging scan.

For cystic pancreatic tumors including intraductal papillary mucinous neoplasms (IPMNs), see our dedicated IPMN page.

Symptoms of a pancreatic tumor

Symptoms differ significantly between exocrine and endocrine tumor types.

Pancreatic ductal adenocarcinoma is notoriously silent in its early stages. When symptoms occur they typically indicate locally advanced or metastatic disease:

• Upper abdominal pain radiating to the back, often worse when lying flat and slightly relieved by leaning forward

• Painless jaundice from bile duct obstruction by a pancreatic head tumour, causing yellow skin and eyes, dark urine, and pale stools

• Unexplained significant weight loss and loss of appetite

• New-onset diabetes in someone without conventional risk factors, or sudden deterioration of previously well-controlled diabetes

• Steatorrhoea from pancreatic exocrine insufficiency

• Nausea, vomiting, and early satiety from gastric outlet compression

• Migratory thrombophlebitis (Trousseau's sign), recurrent superficial vein thrombosis, is a paraneoplastic feature

Pancreatic neuroendocrine tumors can cause symptoms from hormone excess or from local tumor growth:

• Insulinoma: recurrent episodes of hypoglycaemia causing confusion, sweating, palpitations, and loss of consciousness, typically in the fasting state or after exercise

• Gastrinoma: severe or recurrent peptic ulcers, diarrhoea, and heartburn from excess acid production

• Glucagonoma: a characteristic skin rash called necrolytic migratory erythema, new-onset diabetes, weight loss, and anaemia

• VIPoma: profuse watery diarrhoea, low potassium, and reduced stomach acid (WDHA syndrome)

• Non-functioning PNETs: often entirely asymptomatic until large, then causing abdominal pain, jaundice from bile duct compression, or weight loss

What causes pancreatic tumors?

The causes differ between exocrine and endocrine tumor types.

Pancreatic ductal adenocarcinoma risk factors include:

• Smoking is the most clearly established modifiable risk factor, responsible for approximately 25% of pancreatic cancers

• Type 2 diabetes and obesity both significantly increase PDAC risk, with diabetes acting as both a risk factor and an early consequence

• Chronic pancreatitis causes progressive ductal epithelial damage raising malignant transformation risk over decades

• Genetic predisposition including BRCA2, PALB2, ATM, CDKN2A, STK11, Lynch syndrome, and hereditary pancreatitis from PRSS1 mutations all confer elevated risk

• Family history of pancreatic cancer in first-degree relatives significantly raises individual risk

• Age incidence rises sharply after 50 and peaks in the seventh decade

Pancreatic neuroendocrine tumor risk factors include:

• Multiple endocrine neoplasia type 1 (MEN1) is the most important inherited cause, causing PNETs alongside parathyroid and pituitary tumors. PNETs in MEN1 are often multiple and require lifelong surveillance.

• Von Hippel-Lindau (VHL) disease is associated with clear cell PNETs

• Tuberous sclerosis is associated with non-functioning PNETs

• Neurofibromatosis type 1 is associated with somatostatinomas

• Sporadic cases account for the majority of PNETs without an identifiable hereditary cause

How is a pancreatic tumor detected?

Pancreatic tumours are mainly assessed with abdominal imaging. Blood tests can provide additional information about liver and pancreatic function, blood sugar, and other findings that may be relevant.

Abdominal MRI Elfcare’s full-body MRI deeply scans your abdomen to catch both common and rare pancreatic tumors earlier than standard imaging. It can measure a pancreatic lesion, assess the pancreatic and bile ducts, and evaluate surrounding structures for features that may indicate local extension or spread. Because rare hormone tumors (PNETs) look distinctly bright and well-defined on an MRI, this scan serves as the most powerful, non-invasive tool available for spotting small growths before symptoms appear.

Blood tests cannot detect pancreatic tumours directly but provide important functional and systemic context. Relevant markers in Elfcare's panel include:

• HbA1c and glucose new-onset or worsening diabetes is both a risk factor for and an early consequence of PDAC, and hypoglycaemia from insulinoma is directly detectable through glucose measurement

• Fasting insulin and C-peptide elevated insulin and C-peptide can support the investigation of an insulin-producing tumour such as an insulinoma

• ALT, AST, GGT, ALP, and bilirubin biliary obstruction from a pancreatic head tumour causes a characteristic pattern of elevated ALP and bilirubin, an important and urgent signal

• Albumin low albumin reflects significant nutritional impairment from pancreatic exocrine insufficiency or advanced malignancy

• CRP elevated systemic inflammation associated with advanced malignancy and pancreatitis

• Calcium and albumin-corrected calcium elevated calcium may provide additional context when a PNET is identified, particularly because MEN1 can be associated with primary hyperparathyroidism

• IGF-1 relevant to the broader hormonal context of functioning neuroendocrine tumors

Why early detection matters

The prognosis of pancreatic ductal adenocarcinoma is almost entirely determined by the stage at diagnosis. Surgically resectable disease, present in only 15 to 20% of patients at diagnosis, has a five-year survival of approximately 20 to 30%. Metastatic disease has a median survival of 6 to 12 months. Pancreatic cancer typically grows for 10 to 15 years before causing symptoms, and this long pre-symptomatic window is the opportunity that proactive abdominal MRI exploits.

For PNETs, early detection matters for different reasons. Small, well-differentiated PNETs identified before they have grown large, metastasised, or caused significant hormonal consequences can be managed with surveillance or curative resection. Non-functioning PNETs identified early are frequently resectable with excellent long-term outcomes. Functioning PNETs identified at the stage of subtle hormonal symptoms, such as episodic hypoglycaemia from a small insulinoma, can be localised and removed before they cause serious harm. An asymptomatic pancreatic mass of either type found on Elfcare's abdominal MRI represents the ideal scenario for changing a potentially fatal diagnosis into a curable one.

How Elfcare can help

Elfcare's full body MRI images the pancreas directly as part of the standard abdominal examination. It can identify both PDAC and PNETs, with PNETs often appearing as well-defined, vascular masses that are identifiable even when small. The pancreas is one of the most clinically important organs in Elfcare's abdominal MRI, and identifying a pancreatic mass before symptoms have developed, whether exocrine or endocrine in origin, is one of the most impactful outcomes the health check can produce.

Our blood panel covers HbA1c, fasting glucose, fasting insulin, liver and biliary markers, calcium, and albumin, providing the functional and metabolic context alongside the structural MRI findings and flagging the hormonal signals most closely associated with both tumour types.

If our MRI or blood tests identify a pancreatic tumor or findings consistent with pancreatic pathology, we take care of further diagnostics or refer you to the appropriate specialist urgently.