Diagnostic Dilemma: A pancreas mass was found in a 56 year old man: is this benign or malignant? (PN01-03)

Patient History:

This 56 year old patient had a long history of chronic pancreatitis. Endoscopic ultrasound examination revealed a new mass in the pancreas head, giving concern for a malignant lesion. However, the cytopathology interpretation of the fine needle aspiration of the mass favored a benign, reactive process. The clinician referred the cytology slide to RedPath for a definitive diagnosis.

Original Diagnosis:

Reactive cellular atypia is favored due to the abundant inflammation present in the specimen. However malignancy cannot be excluded. (Indeterminate for malignancy, benign is favored.)

RedPath Diagnosis:

Multiple high-percentage allelic imbalance mutations of chromosomes 1p, 9p, 10q, and 17q. This confirms the presence of pancreatic adenocarcinoma.

Generic sample of PathFinderTG® quantitative test results. NOTE: A diagnostic interpretation of the quantitative test results is provided by the RedPath Pathologist.
Click here for test result explanation

Clinical Impact:

Pancreatic adenocarcinoma is among the most aggressive of all cancers, with virtually no chance of survival once it has spread beyond the pancreatic area. Clinicians often recommend surgical resection of the entire pancreas (Whipple Procedure) when there is a diagnosis of pancreatic adenocarcinoma.

In this case, the RedPath PathFinderTG diagnosis unequivocally confirmed the presence of pancreatic cancer, allowing the doctor to schedule a surgical treatment immediately without need for further expensive and time-consuming confirmatory tests or follow-up surveillance that would delay treatment. Had RedPath testing not been performed, the patient may have had surgery delayed because of the equivocal results of the cytopathology diagnosis, thus sharply decreasing the possibility of a favorable outcome.