Malignant Neoplasm of the Pancreas B001

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/m/malignant-neoplasm-pancreas-b001-c250c251c252c25

Last amended

Rulebase for malignant neoplasm of the pancreas

<h5>Current RMA Instruments</h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2021/4f211df748/103.pdf&quot; target="_blank">Reasonable Hypothesis</a></address></td><td>103 of 2021</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2021/47b505c3f7/104.pdf&quot; target="_blank">Balance of Probabilities</a></address></td><td>104 of 2013</td></tr></tbody></table><h5>Changes from previous Instruments</h5><p><drupal-media data-entity-type="media" data-entity-uuid="f80b9e71-159f-4be0-ad34-897ff37e07e4" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding</h5><ul><li>ICD-9-CM Codes: 157.0-3, 157.8</li><li>ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.</li></ul><h5>Brief description</h5><p>This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.</p><p>The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.</p><h5>Confirming the diagnosis</h5><p>This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.</p><p>The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.</p><h5><b>Additional diagnoses covered by SOP</b></h5><ul><li>Adenocarcinoma of the pancreas</li><li>Mucinous cystadenocarcinoma of the pancreas</li><li>Pancreatoblastoma</li></ul><h5><b>Conditions not covered by SOP</b></h5><ul><li>Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP</li><li>Carcinoid of the pancreas<span><sup>#</sup></span></li><li>Endocrine tumours of the pancreas<span><sup>#</sup></span></li><li>gastrinoma<span><sup>#</sup></span></li><li>glucagonoma<span><sup>#</sup></span></li><li>insulinoma<span><sup>#</sup></span></li><li>islet cell tumour<span><sup>#</sup></span></li><li>VIPoma<span><sup>#</sup></span></li><li>Hodgkin’s lymphoma of the pancreas*</li><li>medullary carcinoma of the pancreas<span><sup>#</sup></span></li><li>Non-Hodgkin lymphoma of the pancreas*</li><li>Soft tissue sarcoma of the pancreas*</li></ul><p>* another SOP applies</p><p><sup><span># </span></sup>non-SOP condition</p><h5>Clinical onset</h5><p>The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.</p><h5>Clinical worsening</h5><p>The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-malignant-neoplasm-pancreas

A partial gastrectomy

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/partial-gastrectomy

Being obese

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/being-obese

Chronic pancreatitis

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/chronic-pancreatitis

Cigar smoking

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/cigar-smoking

Cigarette smoking

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/cigarette-smoking

Diabetes mellitus

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/diabetes-mellitus

Exposure to DDT

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/exposure-ddt

No appropriate clinical management for malignant neoplasm of the pancreas

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/no-appropriate-clinical-management-malignant-neoplasm-pancreas

Pipe smoking

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/pipe-smoking

Smoking tobacco products - material contribution

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/smoking-tobacco-products-material-contribution

Using smokeless tobacco

Current RMA Instruments
Reasonable Hypothesis
103 of 2021
Balance of Probabilities
104 of 2013
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 157.0-3, 157.8
  • ICD-10-AM Codes: C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8.
Brief description

This is a primary malignant neoplasm of the exocrine pancreas. The SOP does not cover benign neoplasms or secondary neoplasms arising from other sources.

The pancreas is composed of: exocrine glands which supply enzymes to the gastrointestinal tract via the pancreatic ducts; and, islands (islets) of endocrine tissue scattered through the pancreas, which secrete hormones (insulin, glucagon, somatostatin) into the blood stream. This SOP only applies to a cancer of the exocrine tissue and not the endocrine tissue.

Confirming the diagnosis

This diagnosis requires histological confirmation from a biopsy or surgical resection of pancreatic tissue. A range of other tests and imaging may be performed.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP
  • Adenocarcinoma of the pancreas
  • Mucinous cystadenocarcinoma of the pancreas
  • Pancreatoblastoma
Conditions not covered by SOP
  • Adenocarcinoma of the ampulla of vater* - malignant neoplasm of the bile duct SOP
  • Carcinoid of the pancreas#
  • Endocrine tumours of the pancreas#
  • gastrinoma#
  • glucagonoma#
  • insulinoma#
  • islet cell tumour#
  • VIPoma#
  • Hodgkin’s lymphoma of the pancreas*
  • medullary carcinoma of the pancreas#
  • Non-Hodgkin lymphoma of the pancreas*
  • Soft tissue sarcoma of the pancreas*

* another SOP applies

# non-SOP condition

Clinical onset

The condition most commonly presents clinically, with symptoms of pain (abdominal or epigastric), jaundice, and weight loss.  A range of other non-specific symptoms may also occur.  Pain is usually of insidious onset and has been present for some time at the time of first presentation.  The condition is occassionally first uncovered as an incidental finding on CT or MRI scan.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition often presents late and has a poor prognosis.  Surgical resection is not possible in most cases. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-pancreas-b001-c250c251c252c25/rulebase-malignant-neoplasm-pancreas/using-smokeless-tobacco