Differential Diagnosis of Pancreatobiliary Carcinoma from Autoimmune Pancreatitis-Related Diseases: A Report of Three Cases

Abstract

Current series of cases would raise an alert on diagnosis of AIP and associated SC, and pancreatobiliary malignancy should be carefully excluded by any means. Surgical intervention would be required in selected cases of this clinical entity.

Pancreatic Ductal Adenocarcinoma Associated with Autoimmune Pancreatitis

“…On the other hand, the serum determination of tumoral markers does not add any useful information because they may also be abnormally high in patients with AIP without the presence of a pancreatic adenocarcinoma [ 26 ]; neither does 18 FDG-PET help in diagnosing the simultaneous presence of pancreatic adenocarcinoma and AIP in the case of the absence of concomitant extrapancreatic uptake by the salivary glands or kidneys [ 27 , 28 ]. Finally, it is also possible that AIP may be associated with biliary malignancies [ 29 ]; thus, additional larger case studies are needed to clarify the association of synchronous or metachronous pancreatobiliary malignancies with AIP. In conclusion, the recommendations of Kawa et al [ 30 ] should be kept in mind; we must carefully monitor AIP patients for the simultaneous presence of pancreatic cancer, even when a diagnosis of AIP is confirmed.…”

Novel quantitative perfusion analysis with contrast-enhanced harmonic EUS for differentiation of autoimmune pancreatitis from pancreatic carcinoma

“…Although typical cases of AIP with diffuse enlargement of the pancreas on CT or MRI could be easily diagnosed, focal AIP with pancreatic mass lesion is sometimes difficult to distinguish from pancreatic carcinoma, in spite of recent advances in imaging tests such as CT, MRI, and PDG-PET [6,8,[34][35][36].…”

“…However, later publications showed that the pancreas could also be focally involved by autoimmune pathology, and the patients with focal AIP demonstrated a painless jaundice in the setting of focal pancreatic mass lesion [5][6][7]. Focal AIP is often misdiagnosed as pancreatic carcinoma in spite of recent advances in the development of imaging modalities [6][7][8][9], and Chari et al reported that the diagnosis could not be confirmed without steroid trial, core biopsy, or surgical resection in 30% of AIP [10]. Therefore, the development of noninvasive tests to distinguish AIP from pancreatic carcinoma is crucial.…”

Autoimmune pancreatitis type 1 and type 2: A report of two cases

“…Clinically, AIP could be asymptomatic, but it could be manifested as acute pancreatitis, sometimes followed by the other organs damage [6][7][8][9][10][11] . It is characterized by diffuse or focal enlargement of the pancreas that sometimes is not easy to differ from pancreatic cancer 7 . The international criteria for AIP used today, established back in 2011, significantly help in recognizing and starting adequate treatment of this disease.…”