Medical Case Reports

An Untypical Autoimmune Pancreatitis and Pancreatic Cancer: Differential Diagnosis Experiences Extracted from Mis-diagnosis of two Cases

Background: Differentiation between pancreatic cancer (PC) and untypical autoimmune pancreatitis (AIP) is very challenging, with similar clinical presentations, laboratory results and morphologic imaging of US, CT, EUS, MRI, ERCP, PET-CT. Even serum IgG4 and biopsy sometimes cannot give clear-cut differential accurate diagnostic value. Considering the totally different management strategy of the two diseases, accurate diagnostic value is urgently needed to remind the clinicians of the rare diagnosis of untypical AIP among frequent PC-suspected patients.

Case presentation: We present 2 laparotomy cases of AIP that had a high similar characteristic to PC and retrospectively extracted the warning signs that may help select untypical AIP in PC-suspected patients.

Discussion and Conclusion: We find that mild fluctuating jaundice with abdominal pain, young age, tumor marker of TPS, TPA and diverse results between variable radiological tests can help to differentiate AIP mass from PC, through retrospectively analyzing work-up process of AIP in two patients who underwent laparotomy for suspected PC.

Author(s):

Gaopeng Li, Ting Liu, Wenqin Kang, Jian Zheng, Jun XU, Zefeng Gao and Jinfeng Ma

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