Only by clarifying the concept of “pancreatic head cancer” and figuring out what kind of disease you have can you get the best treatment. Concept: Clinically, the so-called “pancreatic head cancer” refers to malignant tumors occurring in the pancreatic head, duodenum and jugular region, which have complex tissue origins (pancreatic gland body, pancreatic duct, distal bile duct, duodenal papilla, duodenum and various tissues around the pancreatic head, biological behavior, imaging characteristics of tumors of different origins and different degrees of differentiation). The biological behavior, imaging characteristics, treatment principles and prognosis of tumors of different origin and differentiation vary greatly. Difficulties: Due to the adjacent location, the clinical manifestations and laboratory tests of the above tumors overlap with each other (obstructive jaundice + regional mass of the pancreatic head + elevated CA19-9), and it is often difficult to distinguish which tumor is which by puncture cytopathology, and the indiscriminate homogenization of treatment is the main reason for the poor overall prognosis of pancreatic head cancer. Classification: 1. According to the origin of tumor 1. pancreatic ductal origin pancreatic ductal adenocarcinoma, IPMN, etc. 2. pancreatic parenchymal origin pancreatic follicular carcinoma, pancreatic neuroendocrine carcinoma, metastasis, lymphoma, etc. 3. bile duct origin distal bile duct carcinoma, pot belly carcinoma 4. duodenal origin duodenal carcinoma, duodenal papillary carcinoma, duodenal mesenchymal tumor 5. parapancreatic origin lymph node metastasis, lymphoma, giant Lymph node hyperplasia 2. Classification according to treatment effect and growth rate 1. Highly malignant tumors with rapid growth rate, including pancreatic ductal adenocarcinoma, lymphoma, metastasis, pancreatic blastoma, etc. 2.Medium to low malignancy tumors with slow growth rate, including neuroendocrine carcinoma, IPMN, mucinous adenocarcinoma, etc. 3, benign or potentially malignant Slow growth rate, including neuroendocrine tumors, pancreatic intraductal papilloma (IPMN,, solid pseudopapillary tumor, cystadenoma, duodenal mesenchymal tumor. Conclusion “Pancreatic head cancer” is a malignant tumor named by anatomical region, which involves more than 10 kinds of tumors, and some of them will be treated better if they can be differentiated. The increasing popularity of pancreatic standardized imaging “thin layer dynamic scan + multiplanar reconstruction + regular follow-up” has greatly improved the ability to identify these tumors, and the following points should be noted when analyzing the images: 1. In addition to individual malignant tumors that originate from abnormal protrusions of the pancreas, most tumors of extra-pancreatic origin have their centers located in the parapancreatic gland and are adjacent to and pushing against the pancreas. 2. Observe the distal pancreas: those without combined pancreatitis are mostly low-grade malignant tumors of extra-pancreatic and intrapancreatic origin. 3.To understand the bile duct and pancreatic duct: those with limited or extensive pancreatic duct dilatation are mostly tumors of pancreatic duct and jugular origin. 4.Comparison of growth rate: The lesions that are significantly enlarged are called “fast growth rate” at an interval of 1 to 2 months for follow-up, which are mostly seen in malignant tumors of pancreatic alveolar origin, while most other tumors are not fast growing. This article is a summary of the author’s clinical practice and only lists the malignant tumors in the pancreatic head region that I have encountered. If rare or rare malignant tumors and a large number of benign lesions without pathological evidence are included in the statistics, there will be many more types of diseases. If treated scientifically, most patients can achieve a significant life-prolonging effect. Objectively speaking, although these lesions are somewhat different in terms of imaging details, experience has not been accumulated enough, and we hope that the majority of patients will understand. (Professional reading by imaging specialists is very important! The patient’s confidence is an important guarantee of a better outcome.