[Pancreatic cancer]

Pancreatic cancer is the fourth leading cause of death due to cancer. The most common cancer in the pancreas is ductal adenocarcinoma. Pancreatic cancer is characterized by alterations in K-Ras, INK4a, Tp53 and SMAD4. Similar to colon cancer a cancer progression model for pancreatic cancer has been proposed. The precursor lesions are called pancreatic intraepithelial neoplasia. Patients with tumors in the head of the pancreas may present deep jaundice without pain. Multidetector CT incorporating dual-phase imaging in the arterial and venous phases of enhancement is the preferred imaging modality for the diagnosis and staging of pancreatic cancer. Gemcitabine is still the standard for unresectable locally advanced disease or distant metastasis.