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but they are important because they are often mistaken for pseudocysts A cystic neoplasm should be suspected when a cystic lesion in the pancreas is found in the absence of a history of pancreatitis Whereas serous cystadenomas (which account for 32 39% of cystic pancreatic neoplasms and also occur in patients with von Hippel Lindau disease) are benign, mucinous cystic neoplasms (defined by the presence of ovarian stroma) (10 45%), intraductal papillary mucinous neoplasms (21 33%), solid pseudopapillary neoplasms (< 5%), and cystic islet cell tumors (3 5%) may be malignant, although their prognoses are better than the prognosis of adenocarcinoma of the pancreas, unless the neoplasm is locally advanced

Pain is present in over 70% of cases and is often vague, diffuse, and located in the epigastrium or left upper quadrant when the lesion is in the tail Radiation of pain into the back is common and sometimes predominates Sitting up and leaning forward may afford some relief, and this usually indicates that the lesion has spread beyond the pancreas and is inoperable Diarrhea, perhaps due to maldigestion, is an occasional early symptom Migratory thrombophlebitis is a rare sign Weight loss is a common but late finding and may be associated with depression Occasionally a patient presents with acute pancreatitis in the absence of an alternative cause Jaundice is usually due to biliary obstruction by a cancer in the pancreatic head A palpable gallbladder is also indicative of obstruction by neoplasm (Courvoisier s law), but there are frequent exceptions A hard, fixed, occasionally tender mass may be present In advanced cases, a hard periumbilical (Sister Joseph s) nodule may be palpable

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The Quick Viewer is a simple yet very useful tool to create reports in SAP without actually doing any programming The quick viewer is similar to an ABAP Query except it does not have all the capabilities that the ABAP query has The quick viewer is more useful than transaction code [SE16n] or [SE16] when you need to query more than one table to obtain the information you require There are standard views in SAP where you can see their structure via transaction code [SE11], which are not tables, but rather a combination of two or more tables You can use these views to display the data using transaction code [SE16] or [SE16n]: VBAKUK A view compiled from VBAK and VBUK KNA1VV A view compiled from KNA1 and KNVV MAPOV A view compiled from Mara and MAKT and MVKE VB_DEBI A view compiled from Mara and KNA1 and KNB1 and BSID The Quick Viewer lets you view the data in more than one table but without a database view you create the view by joining two or more tables The Quick Viewer may be found in the following menu path

There may be mild anemia Glycosuria, hyperglycemia, and impaired glucose tolerance or true diabetes mellitus are found in 10 20% of cases The serum amylase or lipase level is occasionally elevated Liver biochemical tests may suggest obstructive jaundice Steatorrhea in the absence of jaundice is uncommon Occult blood in the stool is suggestive of carcinoma of the ampulla of Vater (the combination of biliary obstruction and bleeding may give the stools a distinctive silver appearance) CA 19-9, with a sensitivity of 70% and a specificity of 87%, has not proved sensitive enough for early detection of pancreatic cancer; increased values are also found in acute and chronic pancreatitis and cholangitis Point mutations in codon 12 of the K-ras oncogene are found in 70 100%, and inactivation of the tumor suppressor genes P16 on chromosome 9, TP53 on chromosome 17, and MADH4 on chromosome 18 is found in 95%, 75%, and 55% of pancreatic cancers, respectively

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