A rare case of IgG4-related systemic disease manifesting with pancreatic head mass mimicking borderline resectable cancer |
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Authors: | Alessandro Franchello Federica Gonella Donata Campra Giorgio Limerutti Mauro Bruno Claudio De Angelis Davide Cassine Gianruggero Fronda Stefano Silvestri |
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Institution: | aDepartment of Surgery, Molinette Hospital, Turin, Italy;bDepartment of Radiology, Molinette Hospital, Turin, Italy;cDepartment of Gastroenterology, Molinette Hospital, Turin, Italy |
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Abstract: | INTRODUCTIONAutoimmune pancreatitis (AIP) is a rare pancreatic disorder among chronic pancreatitis that can mimick pancreatic cancer (PC). Patients with type 1 AIP usually present obstructive jaundice associated with high level of IgG4 in serum and a pancreatic mass at radiological imaging; these disorders may be associated with other organs lesions presenting the same histopathological features, and in these cases AIP should be considered a pancreatic localization of an IgG4-related systemic disease.PRESENTATION OF CASEWe report the case of a young man with initial suspect of PC to be treated with surgery, and final diagnosis of AIP in the context of an IgG4-related systemic disease.DISCUSSIONBecause of its similar features, several algorithms have been proposed for AIP diagnosis, based on combination of clinical/serological and radiological criteria. However, histology represents the only way to obtain definitive diagnosis, even if sometimes it is difficult to obtain biological samples.CONCLUSIONIgG4-related systemic disease must be taken into account among differential diagnosis during the workup for PC, in order to avoid unnecessary surgery. |
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Keywords: | IgG4-related disease Autoimmune pancreatitis Pancreatic cancer |
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