Difference between ampullary tumor and pancreatic cancer

The main differences between ampullary tumors and pancreatic cancer are the location of occurrence, symptoms, and treatment methods. Ampullary tumors are located in the ampullary of the duodenum, while pancreatic cancer mainly occurs in the pancreas, with different histological characteristics and treatment methods. Understanding the difference between the two can help with early detection and correct diagnosis, and then develop a reasonable treatment plan.

1. Site of disease and pathological characteristics

Ampullary tumors are located in the ampullary part of the duodenal papilla, which is the intersection of the bile duct and pancreatic duct openings. Tumors in this area are mostly adenocarcinomas, and because they are closer to the duodenum and biliary system, they may cause symptoms in the early stages of the tumor. Pancreatic cancer occurs in the pancreas itself, often in the head, body, or tail of the pancreas. Pancreatic ductal adenocarcinoma is the most common type of pancreatic cancer, and cancer cells easily invade surrounding tissues, and early symptoms are often not obvious.

2 Symptoms

Because ampullary tumors are close to the bile duct, they may cause obstruction of bile outflow in the early stages, leading to obstructive jaundice, including yellowing of the skin, dark yellow urine, and lighter stool color. Some patients may experience abdominal pain, weight loss, nausea and vomiting. The early symptoms of pancreatic cancer are more hidden. Once they appear, patients may feel upper abdominal pain that often radiates to the back, weight loss, unexplained jaundice, or symptoms of diabetes. In contrast, ampullary tumors are easier to detect due to early obstruction symptoms.

3. Diagnosis

For both diseases, imaging is key. Endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and CT scans are commonly used diagnostic tools. Ampullary tumors can also be diagnosed by duodenoscope biopsy, while the diagnosis of pancreatic cancer may require a puncture biopsy combined with tumor markers such as CA19-9.

4 Treatment methods

Surgical resection is the first choice for ampullary tumors, and the Whipple procedure is often used for pancreaticoduodenectomy. The surgical effect is more stable than pancreatic cancer because ampullary tumors often occur earlier. Postoperative combined radiotherapy or chemotherapy can improve the cure rate. However, the treatment of pancreatic cancer is more difficult. Surgery is suitable for early localized lesions, while radiotherapy and chemotherapy such as gemcitabine or FOLFIRINOX are more often used to prolong survival in the late stage. Targeted therapy or immunotherapy can also be used as exploratory means.

Early diagnosis and treatment of ampullary tumors and pancreatic cancer are crucial. Once upper abdominal pain, jaundice or other discomfort symptoms occur, you should seek medical attention for imaging examinations and related evaluations in a timely manner to accurately diagnose and quickly implement treatment.