Mass-forming pancreatitis with positive fluoro-2-deoxy-d-glucose positron emission tomography and positive diffusion-weighted imaging-magnetic resonance imaging: Report of a case

Differential diagnosis between pancreatic carcinoma and tumor-forming pancreatitis remains difficult, which can cause serious problem because the management and prognosis of these two focal pancreatic masses are entirely different. We report herein a case of tumor-forming pancreatitis mimicking pancreatic carcinoma in an 80-year-old woman.Computed tomography revealed a solid mass in the head of the pancreas, and endoscopic retrograde cholangiopancreatography showed a complete obstruction of the main pancreatic duct in the head of the pancreas.Dynamic contrast-enhanced MRI demonstrated a time-signal intensity curve (TIC) with a slow rise to a peak (1 min after administration of contrast material), followed by a slow decline at the pancreatic mass, indicating fibrotic pancreas. Under the diagnosis of tumor-forming pancreatitis, the patient underwent a segmental pancreatectomy instead of a pancreaticoduodenectomy. The histopathology of the pancreatic mass showed chronic pancreatitis without malignancy. The pancreatic TIC obtained from dynamic-contrast MRI can be helpful in differentiating tumor-forming pancreatitis from pancreatic carcinoma and in avoiding any unnecessary major pancreatic surgery.

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Utility of preoperative dynamic magnetic resonance imaging of the pancreas in diagnosing tumor-forming pancreatitis that mimics pancreatic cancer: Report of a case

Kuroki

Tajima

Tsuneoka

et al. 2009

Surg Today

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Xanthogranulomatous pancreatitis mimicking a malignant cystic tumor of the pancreas: Report of a case

et al. 2011

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Xanthogranulomatous pancreatitis (XGP) is a rare inflammatory disease of the pancreas. A correct diagnosis is usually made only after pathological examination. A 76-year-old man was referred to our hospital for investigation of erythroderma, muscle weakness, and weight loss. We suspected dermatomyositis as a paraneoplastic phenomenon and investigated accordingly. Computed tomography showed a cystic lesion encapsulated by a thick wall in the pancreatic body. On magnetic resonance imaging, the lesion had low intensity on the T1-weighted images and heterogeneously high intensity on the T2-weighted images. (18)F-Fluorodeoxyglucose positron emission tomography showed abnormal uptake with a maximum standardized uptake value of 9.1. Based on these findings, we made a preoperative diagnosis of intraductal papillary-mucinous carcinoma and performed a distal pancreatectomy. Macroscopically, the cyst was surrounded by a yellow-tan mass with an unclear border, and was filled with hemorrhagic and necrotic tissue. Microscopically, the mass contained an aggregation of many foamy histiocytes, lymphocytes, and plasma cells. These microscopic findings were consistent with xanthogranulomatous inflammation, and the lesion was diagnosed as XGP. Although it is a rare benign pancreatic lesion, XGP should nevertheless be considered in the differential diagnosis of cystic lesions of the pancreas.

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Pancreaticoduodenectomies in patients without periampullary neoplasms: lesions that masquerade as cancer

Hurtuk¹,

Shoup²,

Oshima³

et al. 2010

The American Journal of Surgery

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Mass-forming pancreatitis with positive fluoro-2-deoxy-d-glucose positron emission tomography and positive diffusion-weighted imaging-magnetic resonance imaging: Report of a case

Cited by 7 publications

References 37 publications

Utility of preoperative dynamic magnetic resonance imaging of the pancreas in diagnosing tumor-forming pancreatitis that mimics pancreatic cancer: Report of a case

Utility of preoperative dynamic magnetic resonance imaging of the pancreas in diagnosing tumor-forming pancreatitis that mimics pancreatic cancer: Report of a case

Xanthogranulomatous pancreatitis mimicking a malignant cystic tumor of the pancreas: Report of a case

Pancreaticoduodenectomies in patients without periampullary neoplasms: lesions that masquerade as cancer

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