International Journal of Gastroenterology

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Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review

Received: Dec. 13, 2019    Accepted: Jan. 02, 2020    Published: Jan. 16, 2020
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Abstract

Pancreatic cancer (PC) is 1 of the deadliest cancers, representing the fourth leading cause of cancer death in the world; This high mortality is due to late symptom onset and because most of the cases of pancreatic cancer are stage IV at diagnosis, and hence not a candidate for curative resection. The following report will serve to emphasize the role of new-onset diabetes in certain patients as a warning sign necessitating further investigation for pancreatic cancer. It’ s about a 46-years old man was admitted in hospital «service of forensic and penitentiary medicine » for jaundice associated with progressive asthenia, abdominal pain, and weight loss. He had been diagnosed with diabetes 4 weeks earlier by his GP. Despite lifestyle changes, he had been commenced on metformin after just 2 weeks due to poor glycaemic control. Physical examination showed a mass of the upper right quadrant on palpation. Computed tomography of the abdomen showing a solid mass of 55 mm in the head of the pancreas, hypodense in particular, with mild Wirsung and bile ducts dilatation, and the focal thrombi is found at the level of the 9 mm splenomersaraic confluent, with hepatic secondary localization images. He was subsequently diagnosed with new-onset diabetes and metastatic pancreatic cancer. The treatment with basal insulin / bolus and anticoagulant therapy was instituted and after stabilization; the patient has been oriented for bilio-pancreatic derivation, and eventual biopsy in a specialized center, but unfortunately the patient died only a few weeks after. PC occurs with increased frequency in patients with type 2 diabetes mellitus (DM2) which is considered the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Although numerous studies have linked both entities since 1833 the mechanism behind this association are complex and not well understood by the moment.

DOI 10.11648/j.ijg.20200401.12
Published in International Journal of Gastroenterology ( Volume 4, Issue 1, June 2020 )
Page(s) 7-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes, Pancreatic Cancer, Diagnosis, Warning Sign

References
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[2] Tammy W. Lo, MSN, ACNP-BC. Screening for Pan in Individuals With Diabetes Mellitus. The Journal for Nurse Practitioners – JNP, 2018; 14 (9): 657-662.
[3] Karnevi E, et al., Intratumoural leukocyte infiltration is a prognostic indicator among pancreatic cancerpatients with type 2 diabetes, Pancreatology (2017), https://doi.org/10.1016/j.pan.2017.11.003.
[4] Asmaa A. Salem, Gerardo G. Mackenzie, Pancreatic cancer: A critical review of dietary risk, Nutrition Research 52 (2018) 1–13.
[5] Zhang ZJ, Qin WJ, Sun YL, Contribution of Biomarkers for Pancreatic Cancer-Associated New-Onset Diabetes to Pancreatic Cancer Screening, Pathology-Research and Practice (2018), https://doi.org/10.1016/j.prp.2018.10.003.
[6] Biadgo B and Abebe M. Association between Type 2 DM and Pancreatic Carcinogenesis, The Korean Journal of Gastroenterology, Vol. 67 No. 4, April 2016.
[7] A. Cignarelli, V. Annamaria Genchi, I. Caruso, A. Natalicchio, S. Perrini, L. Laviola, F. Giorgino, Diabetes and cancer: pathophysiological fundamentals of a ‘dangerous affair’, Diabetes Research and Clinical Practice (2018), doi: https://doi.org/10.1016/j.diabres.2018.04.002.
[8] Donghui Li, Diabetes and Pancreatic Cancer, Mol Carcinog. 2012 January; 51 (1): 64–74. doi: 10.1002/mc.20771.
[9] McAuliffe & Christein, Type 2 Diabetes Mellitus and Pancreatic Cancer, Surg Clin N Am 93 (2013) 619–627.
[10] Zheng Z, et al. Risk Factors for Pancreatic Cancer in China: A Multicenter Case-Control Study, J Epidemiol 2016.
[11] C. Sacerdote, F. Ricceri, Epidemiological dimensions of the association between type 2 diabetes and cancer: a review of observational Studies. Diabetes Research and Clinical Practice (2018), doi: https:// doi.org/10.1016/j.diabres.2018.03.002.
[12] G. Aggarwal et al. New-onset diabetes in pancreatic cancer: A study in the primary care setting. Pancreatology 12 (2012) 156e161.
[13] Donghui Li and Yixiang Mao. Diabetes as a Risk Factor of Pancreatic Cancer. Pancreapedia: Exocrine Pancreas Knowledge BaseVersion 1.0, January 14, 2015 [DOI: 10.3998/panc.2015.2].
[14] T. MUNIRAJ and S. T. CHARI. Diabetes and pancreatic cancer. Minerva Gastroenterol Dietol. 2012 December; 58 (4): 331–345.
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[16] Caroline Sharratt, Varadarajan Baskar. Diabetes as a presenting feature of pancreatic cancer: A case report. Diabetes & Primary Care Vol 11 No 4 2009.
[17] Morales-Oyarvide V, et al., Diabetes mellitus in intraductal papillary mucinous neoplasm of the pancreas is associated with high-grade dysplasia and invasive carcinoma, Pancreatology (2017), http://dx.doi.org/10.1016/j.pan.2017.08.073.
[18] De Souza et al. Diabetes Type 2 and Pancreatic Cancer: A History Unfolding. JOP. 2016 March; 17 (2): 144–148.
[19] Rahul Pannala, Ananda Basu, Gloria M Petersen, Suresh T Chari. New-onset diabetes: a potential clue to the early diagnosis of pancreatic cancer. Lancet Oncol2009; 10: 88–95.
[20] Slim et al. Diabetes mellitus as an early symptom of pancreatic cancer diagnosed three years later Annalesd’ Endocrinologie 70 (2009) 76–79.
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  • APA Style

    Nassima Dekdouk, Radia Yala, Sofiane Hamma, Salim Daoud, Charafa Bouderies, et al. (2020). Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review. International Journal of Gastroenterology, 4(1), 7-10. https://doi.org/10.11648/j.ijg.20200401.12

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    ACS Style

    Nassima Dekdouk; Radia Yala; Sofiane Hamma; Salim Daoud; Charafa Bouderies, et al. Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review. Int. J. Gastroenterol. 2020, 4(1), 7-10. doi: 10.11648/j.ijg.20200401.12

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    AMA Style

    Nassima Dekdouk, Radia Yala, Sofiane Hamma, Salim Daoud, Charafa Bouderies, et al. Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review. Int J Gastroenterol. 2020;4(1):7-10. doi: 10.11648/j.ijg.20200401.12

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  • @article{10.11648/j.ijg.20200401.12,
      author = {Nassima Dekdouk and Radia Yala and Sofiane Hamma and Salim Daoud and Charafa Bouderies and Djamil Azzouz and Rachid Belhadj},
      title = {Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review},
      journal = {International Journal of Gastroenterology},
      volume = {4},
      number = {1},
      pages = {7-10},
      doi = {10.11648/j.ijg.20200401.12},
      url = {https://doi.org/10.11648/j.ijg.20200401.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijg.20200401.12},
      abstract = {Pancreatic cancer (PC) is 1 of the deadliest cancers, representing the fourth leading cause of cancer death in the world; This high mortality is due to late symptom onset and because most of the cases of pancreatic cancer are stage IV at diagnosis, and hence not a candidate for curative resection. The following report will serve to emphasize the role of new-onset diabetes in certain patients as a warning sign necessitating further investigation for pancreatic cancer. It’ s about a 46-years old man was admitted in hospital «service of forensic and penitentiary medicine » for jaundice associated with progressive asthenia, abdominal pain, and weight loss. He had been diagnosed with diabetes 4 weeks earlier by his GP. Despite lifestyle changes, he had been commenced on metformin after just 2 weeks due to poor glycaemic control. Physical examination showed a mass of the upper right quadrant on palpation. Computed tomography of the abdomen showing a solid mass of 55 mm in the head of the pancreas, hypodense in particular, with mild Wirsung and bile ducts dilatation, and the focal thrombi is found at the level of the 9 mm splenomersaraic confluent, with hepatic secondary localization images. He was subsequently diagnosed with new-onset diabetes and metastatic pancreatic cancer. The treatment with basal insulin / bolus and anticoagulant therapy was instituted and after stabilization; the patient has been oriented for bilio-pancreatic derivation, and eventual biopsy in a specialized center, but unfortunately the patient died only a few weeks after. PC occurs with increased frequency in patients with type 2 diabetes mellitus (DM2) which is considered the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Although numerous studies have linked both entities since 1833 the mechanism behind this association are complex and not well understood by the moment.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review
    AU  - Nassima Dekdouk
    AU  - Radia Yala
    AU  - Sofiane Hamma
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    PB  - Science Publishing Group
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    AB  - Pancreatic cancer (PC) is 1 of the deadliest cancers, representing the fourth leading cause of cancer death in the world; This high mortality is due to late symptom onset and because most of the cases of pancreatic cancer are stage IV at diagnosis, and hence not a candidate for curative resection. The following report will serve to emphasize the role of new-onset diabetes in certain patients as a warning sign necessitating further investigation for pancreatic cancer. It’ s about a 46-years old man was admitted in hospital «service of forensic and penitentiary medicine » for jaundice associated with progressive asthenia, abdominal pain, and weight loss. He had been diagnosed with diabetes 4 weeks earlier by his GP. Despite lifestyle changes, he had been commenced on metformin after just 2 weeks due to poor glycaemic control. Physical examination showed a mass of the upper right quadrant on palpation. Computed tomography of the abdomen showing a solid mass of 55 mm in the head of the pancreas, hypodense in particular, with mild Wirsung and bile ducts dilatation, and the focal thrombi is found at the level of the 9 mm splenomersaraic confluent, with hepatic secondary localization images. He was subsequently diagnosed with new-onset diabetes and metastatic pancreatic cancer. The treatment with basal insulin / bolus and anticoagulant therapy was instituted and after stabilization; the patient has been oriented for bilio-pancreatic derivation, and eventual biopsy in a specialized center, but unfortunately the patient died only a few weeks after. PC occurs with increased frequency in patients with type 2 diabetes mellitus (DM2) which is considered the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Although numerous studies have linked both entities since 1833 the mechanism behind this association are complex and not well understood by the moment.
    VL  - 4
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Author Information
  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

  • Department of Forensic and Penitentiary Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria

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