Autoimmune pancreatitis mimicking pancreatic cancer

Abstract

Context: Autoimmune pancreatitis is a particular type of pancreatitis of presumed autoimmune etiology, it is an entity distinct from all others forms of chronic pancreatitis, characterized by clinical, histopathological, radiographic, serologic and therapeutic features. This benign disease resembles pancreatic carcinoma both clinically and radiographically.

Case report: A 27-year-old man presented with obstructive jaundice and evocative image of pancreatic tumor. A pancreaticoduodenectomy (Whipple operation) was performed and pathological examination of the specimen diagnosed AIP. Patient responded well to a course of corticosteroids with resolution of clinical and biological disorders.

Conclusion: Accurate and timely diagnosis of autoimmune pancreatitis is particularly important because steroid therapy is effective and pancreatic resection is not necessary.

Keywords: Autoimmune diseases; chronic pancreatitis; obstructive jaundice; pancreatic neoplasm; steroids.

Fig. 1

Pancreatic phase contrast-enhanced axial CT image shows diffuse enlargement and loss of lobulation of pancreas surrounded by capsule-like rim of low-attenuation soft tissue

Fig. 2

MRCP showing important intrahepatic biliary dilatation (more pronounced on the left) and a saccular dilatation of the common bile duct.