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Case Reports
. 2020:74:63-65.
doi: 10.1016/j.ijscr.2020.07.070. Epub 2020 Jul 28.

Pancreatic sarcoidosis mimicking neoplasia: Case report

Georges Chedid  1 , Jad Gerges Harb  1 , Hussein A Noureldine  1 , Claude Tayar  2 , Selim M Nasser  3 , Nada Abbas Sabbah  1
Affiliations
Case Reports

Pancreatic sarcoidosis mimicking neoplasia: Case report

Georges Chedid et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Although sarcoidosis rarely involves the pancreas, such involvement may mimic pancreatic cancer. We herein report a case of pancreatic sarcoidosis giving rise to a cancer-mimicking retention cyst, concomitant with a neuroendocrine adenoma.

Presentation of case: A 47-year-old Caucasian male presented to follow-up for a benign-appearing cyst of the tail of the pancreas, detected incidentally on CT scan done for a urinary stone in 2017. He had been asymptomatic since his last presentation. The lesion was found to have increased in size from 1 cm to 3 cm in greater diameter. Yet, a CT angiography showed no evidence of invasion of surrounding organs, vessels, or lymph nodes. The patient had previous medical history of treated sarcoidosis, hypertension, recurrent nephrolithiasis, and gout. Due to the size increment a neoplastic cystic lesion was considered and distal pancreatectomy was performed. Pathologic examination revealed a retention cyst associated with chronic pancreatitis and the presence of non-caseating granulomas consistent with sarcoidosis. In addition, a neuroendocrine adenoma, and an adjacent focus of pancreatic intraepithelial neoplasia-1 and 2 were noted.

Discussion: Such presentations may be asymptomatic, as in this case, and a multidisciplinary workup is often required. Care must be taken to rule out pancreatic cancer. A possible relationship between pancreatic sarcoidosis and pancreatic cancer merits further study.

Conclusion: The diagnosis of pancreatic sarcoidosis is difficult, and conclusive diagnosis requires histopathologic assessment.

Keywords: Case report; Histopathology; Incidental; Pancreatic cancer; Pancreatic retention cyst; Sarcoidosis.

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Figures

Fig. 1
Fig. 1
Radiology: Pancreatic Cyst. White arrow marks the pancreatic cyst, a 3 cm lesion with mural nodules and enhancing wall.
Fig. 2
Fig. 2
Pathology: Retention Cyst. Pathology shows the retention cyst (to the right of the image) and a granuloma (to the left) (H&E × 50).
Fig. 3
Fig. 3
Pathology: Sarcoid Granulomas. Pathology shows several granulomas (center and left) and the pancreatic parenchyma (right) (H&E × 200).
See this image and copyright information in PMC

References

    1. Agostini C., Adami F., Semenzato G. New pathogenetic insights into the sarcoid granuloma. Curr. Opin. Rheumatol. 2000;12(1):71–76. - PubMed
    1. Alizadeh L., Alizadeh A.H.M. Pancreatic sarcoidosis: a literature review. Korean J. Pancreas Biliary Tract. 2016;17:566–573.
    1. Agha R. The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines. Int. J. Surg. 2018;60:132–136. - PubMed
    1. Matsuura S. Sarcoidosis with pancreatic mass, endobronchial nodules, and miliary opacities in the lung. Intern. Med. 2017;56(22):3083–3087. - PMC - PubMed
    1. Warren K.W. Surgical treatment of pancreatic cysts: review of 183 case. Ann. Surg. 1966;163:886–891. doi: 10.1097/00000658-196606000-00009. - DOI - PMC - PubMed

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