Journal of Clinical Cases

Chronic Autoimmune Pancreatitis Mimicking A Tumor Of The Head Of The Pancreas

Adel Jelassi, Sawssen Ben Marzouk , Wael Ferjaoui,Nizar Cherni, Mohamed Hedi Mannai,Mohamed Bechir Khalifa

Department of General surgery, Military University Hospital, Faculty of medicine of Tunis, University of Tunis El Manar
Department of Urology, Military University Hospital, Faculty of medicine of Tunis, University of Tunis El Manar

Corresponding Author: Wael Ferjaoui

ABSTRACT

Several pathologies of the pancreas can manifest as solid lesions mimicking tumoral masses, notably a tumor of the head of the pancreas. 5 to 10% of pancreatectomies are performed for pseudo-tumoral lesions of the pancreas, considered as tumors preoperatively and diagnosed as benign pathologies on anatomopathological examination. These include sarcoidosis, intrapancreatic accessory spleen, lymphoid hyperplasia, lymphangioma, endometriosis and chronic pancreatitis [1]. The two forms of chronic pancreatitis that can cause a pseudotumoral mass that is difficult to diagnose as carcinoma are autoimmune pancreatitis and paraduodenal pancreatitis [2]. autoimmune pancreatitis may be isolated (type 2) or part of IgG disease (type 1). Type 2 autoimmune pancreatitis is defined by the destruction of the ductal epithelium by neutrophils. Symptoms appear at around 40 years of age. Twenty to 30% of patients have associated chronic inflammatory bowel disease [3]. diagnosis remains difficult, even with pancreatic biopsy.the fear is to perform major surgery for a benign lesion that responds to corticosteroids. We report the case of a 67-year-old patient who presented with jaundice and a diagnosis of unresectable carcinoma of the head of the pancreas due to vascular relationships. After a double biliary digestive bypass, the diagnosis of type 2 autoimmune pancreatitis was made on the basis of a pancreatic biopsy after total disappearance of the mass in the head of the pancreas