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A Diagnostic Challenge: Pancreatic Cancer or Autoimmune Pancreatitis?
I M Cazacu1,2, A A L Chavez1, A Saftoiu2
1Department of Gastroenterology, Hepatology, and Nutrition, University of Texas-MD Anderson Cancer Center, Houston, Texas, USA.
Current Health Sciences Journal
|January 29, 2019
Summary
We describe a rare case of seronegative autoimmune pancreatitis (AIP) mimicking pancreatic cancer. Steroid treatment confirmed the diagnosis and resolved symptoms, underscoring diagnostic challenges in pancreatic masses.
Area of Science:
- Gastroenterology and Hepatology
- Oncology
- Immunology
Background:
- Pancreatic masses pose diagnostic challenges, often mimicking pancreatic cancer.
- Seronegative autoimmune pancreatitis (AIP) is a rare condition that can present atypically.
Purpose of the Study:
- To report a rare case of seronegative autoimmune pancreatitis (AIP) initially misdiagnosed as pancreatic cancer.
- To highlight the diagnostic difficulties in differentiating AIP from pancreatic malignancy.
- To emphasize the therapeutic and diagnostic role of corticosteroids in AIP.
Main Methods:
- Clinical presentation and imaging findings suggestive of pancreatic cancer.
- Endoscopic ultrasound-guided biopsies to rule out malignancy.
- Repeat imaging showing diffuse pancreatic swelling.
- Therapeutic trial of corticosteroid treatment.
Main Results:
- Biopsies were negative for malignancy.
- Initial focal lesion evolved into diffuse pancreatic swelling.
- Dramatic symptom resolution and normalization of imaging and laboratory parameters following corticosteroid therapy.
Conclusions:
- Seronegative autoimmune pancreatitis can present as a focal pancreatic mass, mimicking pancreatic cancer.
- Corticosteroid therapy is both diagnostic and therapeutic for autoimmune pancreatitis.
- A high index of suspicion and careful diagnostic evaluation are crucial for managing pancreatic masses.
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