Pancreatic and Hepatobiliary Cancer - Podcast

Explore pancreatic and hepatobiliary cancers through four comprehensive patient cases in this 37-minute medical podcast episode. Examine a 63-year-old man presenting with painless jaundice, pruritus, and weight loss to understand the differential diagnosis for obstructive cholestasis, covering both malignant causes (pancreatic head cancer, cholangiocarcinoma, ampullary tumors) and benign causes (stones, strictures). Learn the diagnostic approach using RUQ ultrasound for ductal dilation assessment, followed by pancreas-protocol CT and EUS-guided FNA to confirm pancreatic adenocarcinoma, plus management strategies based on resectability criteria and adjuvant chemotherapy options. Analyze a 58-year-old man with cirrhosis and a newly detected liver nodule during routine surveillance, focusing on hepatocellular carcinoma (HCC) diagnosis through elevated AFP and characteristic imaging findings, including curative treatment options for early-stage disease such as surgical resection, radiofrequency ablation, and transplant considerations under Milan criteria. Study a 48-year-old woman with primary sclerosing cholangitis and rising cholestasis to understand perihilar cholangiocarcinoma (Klatskin tumor), including the role of MRCP for stricture mapping, ERCP with brushings for malignancy confirmation, and surgical approaches with adjuvant capecitabine for localized disease. Review a 72-year-old woman with porcelain gallbladder and new mass to examine gallbladder carcinoma, emphasizing the importance of RUQ ultrasound for polypoid lesions and how staging determines surgical approach, from simple laparoscopic cholecystectomy for T1a disease to extended cholecystectomy for deeper invasion. Master diagnostic strategies including appropriate imaging modalities for different anatomical locations and understand how staging drives treatment decisions across all hepatobiliary malignancies.