[Diagnosis of pancreatic tumors]

Ductal carcinoma is the most frequent pancreatic neoplasm. The other tumours are cystic tumours, intraductal neoplasms, and endocrine tumours; some of these neoplasms have a malignant potential. Main symptoms of ductal carcinoma are epigastric pain, weight loss, and cholestatic jaundice for cephalic tumours; other tumours have varying symptoms and can be discovered fortuitously. Serum assay of CA 19-9 is neither sensitive nor specific for diagnosis of ductal carcinoma. For diagnosis of ductal carcinoma, helical CT scan has a 90% sensitivity and only fails to detect tumours less than 2 cm. Endoscopic ultrasound is efficient for diagnosis of small tumours and allows fine needle aspiration for pathological examination whatever tumour diameter. Staging (locoregional and metastatic extension) is mainly done by helical CT scan.