A 70-year-old man presents with painless progressive jaundice, 10 kg weight loss over 3 months, and a palpable gallbladder. CT shows a 3 cm mass in the head of the pancreas causing ductal dilatation. CA 19-9 is 680 U/mL. On CT, the superior mesenteric vein (SMV) shows < 180° tumour contact without deformity. This tumour is classified as:

• A Borderline resectable pancreatic cancer
• B Locally advanced unresectable pancreatic cancer
• C Resectable pancreatic cancer ✓
• D Metastatic pancreatic cancer

Explanation

Per NCCN/AHPBA criteria, resectable pancreatic cancer has no arterial contact (SMA, celiac, common hepatic artery) and either no venous contact or ≤ 180° contact with the SMV/portal vein without deformity or occlusion. The described case meets these criteria. Borderline resectable involves > 180° venous contact or arterial abutment ≤ 180°. Locally advanced involves arterial encasement > 180° or unresectable venous involvement. CA 19-9 elevation and palpable gallbladder (Courvoisier's sign) support diagnosis but do not determine resectability.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.