In simple words: Cancer in the head of the pancreas is when abnormal cells grow out of control in the head of your pancreas.  This can cause symptoms like belly pain, yellowing of the skin and eyes, weight loss, and feeling tired. Doctors diagnose it with exams, blood tests, and scans like CT or MRI scans. Treatment usually includes surgery, chemo, or radiation, depending on how advanced the cancer is.

Malignant neoplasm of the head of pancreas refers to abnormal growth of pancreatic cells that can spread rapidly to nearby tissues, blood vessels, or lymphatic vessels. It most commonly occurs in chronic smokers and patients suffering from diabetes mellitus, chronic pancreatitis, and obesity; a genetic predisposition may also be a factor. The pancreas is an organ in the abdomen that produces substances to aid in digestion and help control blood sugar. The pancreatic head is the widest part that connects it to the duodenum, which has an inferior projection called the uncinate process. A patient with malignant neoplasm of the head of pancreas initially experiences generalized symptoms such as weakness, depression, loss of appetite, nausea, back pain or mid epigastric pain, and weight loss. However, because initial symptoms are so vague, most patients present with advanced disease characterized by jaundice (yellow discoloration of skin and eyes), ascites (abnormal collection of fluid in abdomen), and liver enlargement due to liver involvement. Providers diagnose the disease based on history, symptoms, and physical examination. Laboratory tests include a blood test for the tumor marker CA 19–9. Imaging studies include CT, MRI, endoscopic retrograde cholangiopancreatography (ERCP), transcutaneous ultrasonography (TUS), endoscopic ultrasonography (EUS), and positron emission tomography (PET). Treatment depends on the stage and location of the neoplasm. If the neoplasm is resectable, surgical management is the primary treatment along with chemotherapy and radiotherapy. For advanced neoplasms, chemotherapy and radiotherapy are used to improve the quality of life. Although survival rates are gradually improving, pancreatic cancer is still considered incurable; only 20 percent live beyond one year of diagnosis and only 7 percent survive to the 5–year benchmark.

Example 1: A 65-year-old patient with a history of smoking and recent weight loss presents with jaundice and abdominal pain. Imaging reveals a mass in the head of the pancreas. Biopsy confirms adenocarcinoma. The patient undergoes a Whipple procedure followed by chemotherapy., A 70-year-old patient with diabetes and chronic pancreatitis experiences worsening back pain and weight loss. A CT scan shows a tumor in the head of the pancreas. Due to the advanced stage of the cancer, the patient receives palliative chemotherapy and radiation therapy to manage symptoms., A 55-year-old patient with no significant risk factors undergoes routine abdominal imaging that incidentally detects a small mass in the head of the pancreas. Biopsy reveals a neuroendocrine tumor. The patient undergoes surgical resection with curative intent.

Documentation should include details of the patient's history, physical exam findings, imaging results (CT, MRI, ERCP, etc.), biopsy results with histologic type and grade, and treatment plan. The documentation must support the diagnosis of malignancy and specify the location within the pancreas (head). If surgery is performed, operative reports should detail the procedure and findings.