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Pancreatic Cancer — RACP Adult Medicine MCQ

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ModerateGastroenterologyPancreatic CancerRACP Adult Medicine

A 50-year-old man presents with epigastric pain, weight loss, and new-onset diabetes. CT abdomen shows a 3 cm mass in the head of the pancreas with no vascular invasion or metastases. CA 19-9 is elevated. Biopsy confirms pancreatic ductal adenocarcinoma. What is the most appropriate management?

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Correct answer: A — Whipple procedure (pancreaticoduodenectomy)

A resectable pancreatic head mass without vascular invasion or metastases is best managed with pancreaticoduodenectomy (Whipple procedure) followed by adjuvant chemotherapy (modified FOLFIRINOX or gemcitabine-capecitabine). Whipple procedure is the standard of care for resectable pancreatic head tumours. Neoadjuvant therapy may be considered for borderline resectable disease.

Reference: AGITG – 2024 – Pancreatic Cancer Guidelines; NCCN 2025