Research Day

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Introduction: Pancreatic cancer is a rare malignancy, with nearly a 100% mortality rate. The strongest risk factor for pancreatic cancer is advanced age; the median age of diagnosis is 70. Here we discuss a case of pancreatic cancer in a 32 year-old woman. Case Description: S.R. is a 32 year-old female presenting with new-onset jaundice. Two months prior to presentation, she reported vomiting and LUQ pain, and was treated for H. pylori. Her symptoms improved, but she developed anorexia, RUQ pain, 35 lb weight loss and clay-colored diarrhea. Her medical history is negative except for 10-pack-year smoking history. Exam revealed a cachectic, jaundiced woman with hepatomegaly and scleral icterus. Labs revealed hyperbilirubinemia of 18.3, and an alkaline phosphatase of 1102. Abdominal CT showed innumerable hypodense lesions throughout the liver and ill-defined pancreatic margins. Liver biopsy was consistent with CA19-9-positive metastatic pancreatic adenocarcinoma. She underwent palliative chemotherapy and died four weeks later. Discussion: Younger patients with pancreatic cancer are often diagnosed at more advanced stages with lower survival rates. Smokers have almost a twofold increased risk compared with nonsmokers, and risk increases with cumulative exposure. Additionally, H. pylori, a proven bacterial carcinogen, has been linked to pancreatic cancer. In a Finnish study of male smokers, participants who tested positive for CagA H. pylori strains were twice as likely to develop pancreatic cancer compared to their seronegative counterparts. Our patient’s strongest risk factors were her smoking history and H. pylori infection. Therefore, one should consider pancreatic cancer even in younger patients with classic symptoms. Moreover, further investigation is needed to help identify those at risk of developing pancreatic cancer at a young age.



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