CHSJ

Curr Health Sci J, vol. 44, no. 2, 2018

A Diagnostic Challenge: Pancreatic Cancer or Autoimmune Pancreatitis?

[Case report]

I.M. CAZACU(1,2), A.A.L. CHAVEZ(1), A. SAFTOIU(2), T. G. WHITLOW(1), P. BHOSALE(3), M. S. BHUTANI(1)


(1)Department of Gastroenterology, Hepatology, and Nutrition, University of Texas-MD Anderson Cancer Center, Houston, Texas, USA,
(2)Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania,
(3)Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas, USA


Abstract:

We report a rare case of seronegative autoimmune pancreatitis (AIP) that presented as a pancreatic focal lesion and was considered to be pancreatic cancer based on the clinical presentation and imaging findings. The endoscopic ultrasound-guided biopsies of the pancreatic mass revealed no malignant cells and the pancreatic swelling had become diffuse on repeat imaging. AIP was suspected and a trial of steroids was considered as a diagnostic and therapeutic method. The patient responded dramatically to corticosteroid treatment with resolution of symptoms and normal imagining and laboratory parameters. This case highlights the challenge in the diagnostic approach of a pancreatic mass.


Keywords: pancreatic cancer; autoimmune pancreatitis; endoscopic ultrasound; endoscopic ultrasound-guided fine-needle aspiration



Corresponding: Manoop S. Bhutani, MD, Gastroenterology, Hepatology and Nutrition, Department, UT MD Anderson Cancer Center, Unit 1466, 1515 Holcombe Blvd., Houston, Texas 77030, USA, e-mail: Manoop.Bhutani@mdanderson.org


DOI 10.12865/CHSJ.44.02.15 - Download PDF
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