Korean J Med.  2013 Dec;85(6):609-613.

Differentiation of Mass-Forming Autoimmune Pancreatitis from Pancreatic Cancer Using A 2-Week Steroid Trial

• Kim J
• Kim JY
• Kang DU
• Kim H
• Moon MY
• Won S
• Kim MH

Abstract

The differentiation of mass-forming autoimmune pancreatitis (AIP) from pancreatic cancer is critical because AIP can be successfully treated with steroid therapy and unnecessary surgery avoided. We herein report a case of 69-year-old male with a prior history of recurrent AIP who developed a pancreatic body mass with upstream duct dilatation. Laboratory findings were nonspecific for AIP or pancreatic cancer, although an endoscopic ultrasonography-guided biopsy revealed chronic inflammation. To differentiate mass-forming AIP from pancreatic cancer, we administered oral steroids for 2 weeks. After steroid therapy, a computed tomography scan revealed a decrease in the pancreatic mass size and improvement in dilatation of the upstream duct. So we could differentiate mass-forming AIP from pancreatic cancer; thereafter resolution of pancreatic lesion could be achieved with further steroid therapy. In conclusion, a 2-week steroid trial followed by radiologic imaging was helpful to differentiate mass-forming AIP from pancreatic cancer.

Keyword

Autoimmune; Pancreatitis; Pancreatic cancer; Steroid; Mass

MeSH Terms

Aged
Biopsy
Dilatation
Humans
Inflammation
Male
Pancreatic Neoplasms*
Pancreatitis*
Steroids
Unnecessary Procedures
Steroids