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Table 2 Summary table of local, nodal and haematogenous spread in pancreatic cancer

From: Common primary tumours of the abdomen and pelvis and their patterns of tumour spread as seen on multi-detector computed tomography

Local spread •Tumour spreads by direct perivascular and perineural invasion;
•Local invasion can involve the stomach, duodenum and retroperitoneum;
Head/uncinate process tumours: these usually extend along the SMA and mesenteric root;
Body/tail tumours: these usually infiltrate the celiac, hepatic or splenic arteries
Lymph node spread Primary drainage: superior, inferior, anterior, posterior and splenic lymph nodes;
Secondary drainage: porta hepatis, common hepatic, coeliac, mesenteric root lymph nodes;
Tertiary drainage: peri-aortic and distal superior mesenteric lymph nodes
Haematogenous spread •These usually involve the liver and peritoneal surfaces
Note •Early lymphatic and haematogenous micrometastases at presentation are common