A 55 year old man presents to a physician with jaundice. Ultrasonography demonstrates a 5 cm mass in the head of the pancreas. Endoscopic retrograde cholangiopancreatography with cytologic sampling demonstrates cells with large hyperchromatic nuclei and a high nuclear/cytoplasmic ratio. A few small glands composed of these cells are also seen in the cytologic preparation. The overall prognosis for this man will be most similar to that of a patient with which of the following malignancies?

The patient probably has pancreatic adenocarcinoma. This cancer carries one of the worst prognoses, with a 3.5% overall 5 year survival rate despite all attempts at aggressive management. The prognosis is also bleak with adenocarcinoma of the esophagus, with a 10% overall 5 year survival rate. Adenocarcinoma of the breast now has an overall 5 year survival rate of 60-70%. Adenocarcinoma of the colon now has an overall 5 year survival rate of 50-60%. Adenocarcinoma of the prostate now has an overall 5 year survival rate of 50-70%. Ref: Fisher W.E., Anderson D.K., Bell R.H., Saluja A.K., Brunicardi F.C. (2010). Chapter 33. Pancreas. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.