Top

Published in:

Open Access 01-12-2011 | GI Image

A Focal Mass-Forming Autoimmune Pancreatitis Mimicking Pancreatic Cancer with Obstruction of the Main Pancreatic Duct

Authors: Ippei Matsumoto, Makoto Shinzeki, Hirochika Toyama, Sadaki Asari, Tadahiro Goto, Isamu Yamada, Tetsuo Ajiki, Takumi Fukumoto, Yonson Ku

Published in: Journal of Gastrointestinal Surgery | Issue 12/2011

Abstract

Introduction and background

Autoimmune pancreatitis (AIP) is a rare disease that closely mimics pancreatic cancer (PC) in its presentation. It is very important for clinicians to distinguish one from the other because their treatment and prognosis are vastly different. Typical radiological imaging findings, in particular observation of diffusely or segmentally narrowed main pancreatic duct (MPD) with an irregular wall by endoscopic retrograde cholangiopancreatography (ERCP), are essential for making the diagnosis of AIP. On the other hand, MPD obstruction is one of the most frequent features on ERCP.

Case report

We report a rare case of a patient with focal mass-forming AIP strongly suspected of being PC because of MPD obstruction on ERCP.

Conclusion

It was difficult to distinguish PC from AIP with current diagnostic modalities. We will continue to make an effort to distinguish between the two disorders to prevent unnecessary surgery.

Okazaki K, Kawa S, Kamisawa T et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol 2006; 41: 626–631.PubMedCrossRef

Wolfson D, Barkin JS, Chari ST et al. Management of pancreatic masses. Pancreas 2005; 31: 203–217.PubMedCrossRef

Kamisawa T, Imai M, Yui Chen P et al. Strategy for differentiating autoimmune pancreatitis from pancreatic cancer. Pancreas 2008; 37: e62–67PubMedCrossRef

Chang WI, Kim BJ, Lee JK et al. The clinical and radiological characteristics of focal mass-forming autoimmune pancreatitis: comparison with chronic pancreatitis and pancreatic cancer. Pancreas 2009; 38: 401–408.PubMedCrossRef

Horiuchi A, Kawa S, Hamano H et al. ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc 2002; 55: 494–499.PubMed

Wakabayashi T, Kawaura Y, Satomura Y et al. Clinical and imaging features of autoimmune pancreatitis with focal pancreatic swelling or mass formation: comparison with so-called tumor-forming pancreatitis and pancreatic carcinoma. Am J Gastroenterol 2003; 98: 2679–2687.PubMedCrossRef

Nishino T, Oyama H, Toki F, Shiratori K. Differentiation between autoimmune pancreatitis and pancreatic carcinoma based on endoscopic retrograde cholangiopancreatography findings. J Gastroenterol 2010; 45: 988–996.PubMedCrossRef

Ghazale A, Chari ST, Smyrk TC et al. Value of serum IgG4 in the diagnosis of autoimmune pancreatitis and in distinguishing it from pancreatic cancer. The American journal of gastroenterology 2007; 102: 1646–1653.PubMedCrossRef

Inoue H, Miyatani H, Sawada Y, Yoshida Y. A case of pancreas cancer with autoimmune pancreatitis. Pancreas 2006; 33: 208–209.PubMedCrossRef

10.

Witkiewicz AK, Kennedy EP, Kennyon L et al. Synchronous autoimmune pancreatitis and infiltrating pancreatic ductal adenocarcinoma: case report and review of the literature. Hum Pathol 2008; 39: 1548–1551.PubMedCrossRef

Title: A Focal Mass-Forming Autoimmune Pancreatitis Mimicking Pancreatic Cancer with Obstruction of the Main Pancreatic Duct
Authors: Ippei Matsumoto
Makoto Shinzeki
Hirochika Toyama
Sadaki Asari
Tadahiro Goto
Isamu Yamada
Tetsuo Ajiki
Takumi Fukumoto
Yonson Ku
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 12/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1543-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A Focal Mass-Forming Autoimmune Pancreatitis Mimicking Pancreatic Cancer with Obstruction of the Main Pancreatic Duct

Abstract

Introduction and background

Case report

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and background

Case report

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2011

Dual-Phase Computed Tomography for Assessment of Pancreatic Fibrosis and Anastomotic Failure Risk Following Pancreatoduodenectomy

Response to Letter to the Editor: Intra-abdominal Pressure and Abdominal Perfusion Pressure Early in Severe Acute Pancreatitis Miss the Forest for the Trees

Biliary Tract Tuberculosis—a Diagnostic Dilemma

Long-Term Outcome of Percutaneous Ablation in Very Early-Stage Hepatocellular Carcinoma

Comparison of Outcomes of Laparoscopic Versus Open Appendectomy in Adults: Data from the Nationwide Inpatient Sample (NIS), 2006–2008

Emergency Management of Perforated Colon Cancers: How Aggressive Should We Be?