Pancreatic Cancer | November 2021-Autoimmune pancreatitis masquerading as pancreatic cancer

Pdf Summary

This video case report discusses a 77-year-old man who presented with painless jaundice, weight loss, and anorexia. Initial imaging revealed a mass in the common bile duct and a pancreatic duct stricture. Further evaluation showed elevated serum immunoglobulin subclass 4 (IgG4) levels, indicating autoimmune pancreatitis (AIP). Endoscopic ultrasound (EUS) revealed diffuse enlargement of the pancreas with a sausage-shaped appearance, consistent with AIP. The presence of the duct penetrating duct sign further supported the diagnosis. A fine-needle biopsy confirmed the presence of IgG4-positive plasma cells, confirming AIP. The patient was started on oral prednisolone and showed improvement in liver function and resolution of pancreatic swelling. A low maintenance dose of prednisolone was prescribed to prevent relapse. This case highlights the importance of recognizing EUS features of AIP in patients presenting with obstructive jaundice and pancreatic mass. Early diagnosis and appropriate management can prevent unnecessary surgical interventions for presumed pancreatic cancer.

Asset Subtitle

Link to audio file: https://www.videogie.org/cms/10.1016/j.vgie.2021.09.001/attachment/88c5e87d-c281-4fc3-8def-d3cf54764ccd/mmc1.mp4

Meta Tag

Disease Pancreatitis

Disease Pancreatic Cancer

Organ & Anatomy Pancreas

Keywords

painless jaundice

weight loss

autoimmune pancreatitis

endoscopic ultrasound

sausage-shaped pancreas