Painless jaundice with weight loss is most suggestive of which cancer?

• A. Lung cancer presenting with cough and weight loss.
• B. Pancreatic cancer presenting with painless jaundice and weight loss.
• C. Colon cancer presenting with blood in stool.
• D. Hepatocellular carcinoma presenting with fever.

Answer: (B)

Painless jaundice with weight loss points to a tumor obstructing the biliary system, most classically cancer of the head of the pancreas. When a pancreatic head tumor grows, it can press on the distal common bile duct, blocking bile flow. This causes conjugated hyperbilirubinemia and jaundice that tends to be painless because the obstruction is gradual rather than inflammatory. The weight loss comes from the cancer’s systemic effects and reduced intake.

In contrast, the other scenarios don’t fit the pattern: lung cancer usually presents with symptoms like a persistent cough; colon cancer often causes blood in the stool; hepatocellular carcinoma typically presents with fever or signs of liver dysfunction rather than painless obstructive jaundice.