Diagnostic clues and subsequent examinations that detected small pancreatic cancer.

Background/Aims: Our aim was to investigate how 2cm or smaller pancreatic cancers were detected successfully in recent years. Methodology: Diagnostic clues and subsequent examinations that detected 15 histologically confirmed 2cm or smaller pancreatic cancers were reviewed. Results: Diagnostic clues were imaging findings in 6 patients, symptoms in 5 and laboratory data in 4. Six of 8 patients who had risk factors of pancreatic cancer such as pancreatic cyst, dilated main pancreatic duct, pancreatitis, or diabetes had been followed-up by imaging and laboratory examinations. Five patients with extrapancreatic disease had been followed-up chiefly by laboratory examinations. The remaining 2 had neither of them. Detectabilities of pancreatic mass in US, CT and EUS were 89%, 67% and 100%, respectively; those of pancreatic mass and/or dilated main pancreatic duct were 100% in all three modalities. Cytological examination revealed adenocarcinoma preoperatively in 14 patients (93%). Conclusions: Small pancreatic cancer of 2cm or smaller were suggested by symptoms, laboratory data, or imaging examinations. They were confirmed by further examinations including cytology.