A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers
Background. Autoimmune pancreatitis (AIP) often mimics pancreatic cancer. The diagnosis of both conditions is difficult preoperatively let alone when they coexist. Several reports have been published describing pancreatic cancer in the setting of AIP. Case Report. The case of a 53-year-old man who p...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2013/809023 |
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| author | Manju D. Chandrasegaram Su C. Chiam Nam Q. Nguyen Andrew Ruszkiewicz Adrian Chung Eu L. Neo John W. Chen Christopher S. Worthley Mark E. Brooke-Smith |
| author_facet | Manju D. Chandrasegaram Su C. Chiam Nam Q. Nguyen Andrew Ruszkiewicz Adrian Chung Eu L. Neo John W. Chen Christopher S. Worthley Mark E. Brooke-Smith |
| author_sort | Manju D. Chandrasegaram |
| collection | DOAJ |
| description | Background. Autoimmune pancreatitis (AIP) often mimics pancreatic cancer. The diagnosis of both conditions is difficult preoperatively let alone when they coexist. Several reports have been published describing pancreatic cancer in the setting of AIP. Case Report. The case of a 53-year-old man who presented with abdominal pain, jaundice, and radiological features of autoimmune pancreatitis, with a “sausage-shaped” pancreas and bulky pancreatic head with portal vein impingement, is presented. He had a normal serum IgG4 and only mildly elevated Ca-19.9. Initial endoscopic ultrasound-(EUS-) guided fine-needle aspiration (FNA) of the pancreas revealed an inflammatory sclerosing process only. A repeat EUS guided biopsy following biliary decompression demonstrated both malignancy and features of autoimmune pancreatitis. At laparotomy, a uniformly hard, bulky pancreas was found with no sonographically definable mass. A total pancreatectomy with portal vein resection and reconstruction was performed. Histology revealed adenosquamous carcinoma of the pancreatic head and autoimmune pancreatitis and squamous metaplasia in the remaining pancreas. Conclusion. This case highlights the diagnostic and management difficulties in a patient with pancreatic cancer in the setting of serum IgG4-negative, Type 2 AIP. |
| format | Article |
| id | doaj-art-2efae86ac2104e70bcd3cbf4770caa0b |
| institution | OA Journals |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-2efae86ac2104e70bcd3cbf4770caa0b2025-08-20T02:38:52ZengWileyCase Reports in Surgery2090-69002090-69192013-01-01201310.1155/2013/809023809023A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum MarkersManju D. Chandrasegaram0Su C. Chiam1Nam Q. Nguyen2Andrew Ruszkiewicz3Adrian Chung4Eu L. Neo5John W. Chen6Christopher S. Worthley7Mark E. Brooke-Smith8Hepatobiliary Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, AustraliaHepatobiliary Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, AustraliaDepartment of Gastroenterology, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaDepartment of Surgical Pathology, SA Pathology, Adelaide, AustraliaDepartment of Gastroenterology, Flinders Medical Centre, Bedford Park, SA 5042, AustraliaHepatobiliary Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, AustraliaHepatobiliary Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, AustraliaHepatobiliary Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, AustraliaHepatobiliary Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, AustraliaBackground. Autoimmune pancreatitis (AIP) often mimics pancreatic cancer. The diagnosis of both conditions is difficult preoperatively let alone when they coexist. Several reports have been published describing pancreatic cancer in the setting of AIP. Case Report. The case of a 53-year-old man who presented with abdominal pain, jaundice, and radiological features of autoimmune pancreatitis, with a “sausage-shaped” pancreas and bulky pancreatic head with portal vein impingement, is presented. He had a normal serum IgG4 and only mildly elevated Ca-19.9. Initial endoscopic ultrasound-(EUS-) guided fine-needle aspiration (FNA) of the pancreas revealed an inflammatory sclerosing process only. A repeat EUS guided biopsy following biliary decompression demonstrated both malignancy and features of autoimmune pancreatitis. At laparotomy, a uniformly hard, bulky pancreas was found with no sonographically definable mass. A total pancreatectomy with portal vein resection and reconstruction was performed. Histology revealed adenosquamous carcinoma of the pancreatic head and autoimmune pancreatitis and squamous metaplasia in the remaining pancreas. Conclusion. This case highlights the diagnostic and management difficulties in a patient with pancreatic cancer in the setting of serum IgG4-negative, Type 2 AIP.http://dx.doi.org/10.1155/2013/809023 |
| spellingShingle | Manju D. Chandrasegaram Su C. Chiam Nam Q. Nguyen Andrew Ruszkiewicz Adrian Chung Eu L. Neo John W. Chen Christopher S. Worthley Mark E. Brooke-Smith A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers Case Reports in Surgery |
| title | A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers |
| title_full | A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers |
| title_fullStr | A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers |
| title_full_unstemmed | A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers |
| title_short | A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers |
| title_sort | case of pancreatic cancer in the setting of autoimmune pancreatitis with nondiagnostic serum markers |
| url | http://dx.doi.org/10.1155/2013/809023 |
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