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Type: Journal article
Title: A case of pancreatic cancer in the setting of autoimmune pancreatitis with nondiagnostic serum markers
Author: Chandrasegaram, M.
Chiam, S.
Nguyen, N.
Ruszkiewicz, A.
Chung, A.
Neo, E.
Chen, J.
Worthley, C.
Brooke-Smith, M.
Citation: Case Reports in Surgery, 2013; 2013:809023-1-809023-6
Publisher: Hindawi Publishing Corporation
Issue Date: 2013
ISSN: 2090-6900
Statement of
Manju D. Chandrasegaram, Su C. Chiam, Nam Q. Nguyen, Andrew Ruszkiewicz, Adrian Chung, Eu L. Neo, John W. Chen, Christopher S. Worthley, and Mark E. Brooke-Smith
Abstract: 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.
Rights: Copyright © 2013 Manju D. Chandrasegaram et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
RMID: 0030021961
DOI: 10.1155/2013/809023
Appears in Collections:Pathology publications

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