Xanthogranulomatous Inflammation of the Peripancreatic Region Mimicking Pancreatic Cystic Neoplasm

Abstract

Xanthogranulomatous inflammation (XGI)

Xanthogranulomatous Pancreatitis Mimicking a Pancreatic Cancer on CT and MRI: a Case Report and Literature Review

“…In earlier stages, xanthogranulomatous change may occur in peripheral wall portion of a pseudocyst or wall-off necrosis while central cystic portion may be preserved. Ikeura et al (10) have reported that marked infiltration of lipid-laden foamy macrophages with fibrosis is seen in the peripheral wall of the cystic mass and the central cavity contains old hemorrhage and necrotic tissue in their case. At this stage, we believe that solid and cystic or cystic mass with thick wall lesion can be misdiagnosed as SPT, IPMN and pseudocyst.…”

“…However, the disease presentation, demographics, and risks are not specific in the previous 17 reports (1,(3)(4)(5)(6)(7)(8)(9)(10). Of the 17 reported cases, xanthogranulomatous pancreatitis was more common (13 of 17) in males.…”

“…The locations of lesions are also not specific, including head (5 of 17), body (7 of 17), tail (4 of 17), and uncinated process (1 of 17). At the time of preoperative diagnosis, 11 patients were presumed as a true neoplastic condition, including 6 patients presumed as pancreatic cancer (1,5,8), 4 patients as IPMN (4,6), and one patient as solid pseudopapillary tumor (SPT) (10). The other 6 patients were suggested as having benign condition including three cases of pseudocyst (3,7) and three cases of chronic pancreatitis (9) through clinico-radiological correlation.…”

Xanthogranulomatous pancreatitis -a rare case defying clinical, radiological and tumor marker diagnostics with a review of literature

“…(1). XGP is a rare entity with only a handful of reports in medical literature (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Out of a total of 4500 cases of chronic cholecystitis diagnosed since 2007 at our institute xanthogranulomatous cholecystitis (XGC) comprised 353 (7.84%).…”

“…Xanthogranulomatous inflammation (XGP) in the pancreas is a rarity but assumes importance as correct diagnosis often is evasive. Of the few reported cases till date (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), nearly all have had normal tumor marker levels. herein, we present the first case of XGP without any associated malignancy demonstrating an elevation of both serum and fluid tumour markers.…”