Endocrine Abstracts

Introduction: Pancreatic cancer is one of the digestive system cancers whose prognosis has not been improved, both in terms of early diagnosis and prognosis, despite the progress in clinical, radiological and biological investigation. A significant number of patients present at the time of diagnosis of this cancer, or just before, a relatively recent onset diabetes. The link between diabetes and pancreatic cancer is established, but it is sometimes difficult to distinguish whether its occurrence is the cause or the consequence of diabetes. Hereby we report 4 observations.

Observation: The 1st case was a 64-year-old woman. The diagnosis of a metastatic biliopancreatic adenocarcinoma was discovered fortuitously on abdominal ultrasound. Palliative chemotherapy was indicated. Diabetes was discovered during the pre-chemotherapy workup with a blood glucose level of 5 g/l. She was on insulin therapy. The 2nd and 3rd cases: Male patients aged 57 and 71 years respectively, diabetic for 1 year and 3 months on Metformin. A pancreatic adenocarcinoma was discovered in front of weight loss and jaundice. Both of them were treated surgically and put on insulin therapy. The 4th case was a man of 84 years old hospitalized for inaugural diabetic ketosis with an altered general condition. During his hospitalization, he developed jaundice associated with abdominal pain. Abdominal ultrasound revealed an extensive process at the head of the pancreas. Discussion-ConclusionThe relationship between pancreatic carcinoma and diabetes has been shown in different studies, but whether it is a cause or a consequence of diabetes is not clear. Pancreatic tumors are three times higher in the diabetic population than in the general population. Pancreatic cancer presents problems that we do not know how to solve, especially the circumstances in which cancer should be sought in a patient with diabetes. In two of our observations diabetes preceded pancreatic cancer. The pathophysiological mechanisms of diabetes mellitus in these cases are multiple. At present, there is no systematic screening strategy for pancreatic cancer in diabetics. Particular attention should be paid to any diabetic patient with disturbances of the liver function.