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http://dx.doi.org/10.3904/kjm.2013.85.6.609

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

Kim, Jeongseok (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Jin Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Kang, Dong-Uk (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Hocheol (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Moon, Min Young (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Won, Sunghyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Myung-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Publication Information
The Korean Journal of Medicine / v.85, no.6, 2013 , pp. 609-613 More about this Journal
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.
Keywords
Autoimmune; Pancreatitis; Pancreatic cancer; Steroid; Mass;
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