Case Report
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World J Gastroenterol. Dec 14, 2014; 20(46): 17674-17679
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17674
Focal autoimmune pancreatitis and chronic sclerosing sialadenitis mimicking pancreatic cancer and neck metastasis
Li Sun, Qiang Zhou, David R Brigstock, Su Yan, Ming Xiu, Rong-Li Piao, Yan-Hang Gao, Run-Ping Gao
Li Sun, Qiang Zhou, Su Yan, Ming Xiu, Rong-Li Piao, Yan-Hang Gao, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, First Hospital, Jilin University, Changchun 130021, Jilin Province, China
David R Brigstock, Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, United States
David R Brigstock, Division of Pediatric Surgery, Department of Surgery, Ohio State University, Columbus, OH 43205, United States
Author contributions: Sun L, Zhou Q, Yan S, Xiu M, Piao RL and Gao YH performed the experiments and analyzed data; Gao RP designed the study and wrote the manuscript; Brigstock DR co-ordinated the study and edited the manuscript.
Supported by National Natural Scientific Foundation, No. 81070370, and No. 81270544 to Gao RP; and National Institutes of Health, No. 5R01AA016003 to Brigstock DR
Correspondence to: Run-Ping Gao, Professor, Department of Hepatic-Biliary-Pancreatic Medicine, First Hospital, Jilin University, 71 Xinmin Avenue, Changchun 130021, Jilin Province, China. gao_runping@yahoo.com
Telephone: +86-431-81715110 Fax: +86-431-85612468
Received: May 1, 2014
Revised: June 8, 2014
Accepted: July 11, 2014
Published online: December 14, 2014
Processing time: 230 Days and 20.3 Hours
Abstract

Type 1 autoimmune pancreatitis (AIP) or chronic sclerosing sialadenitis (Küttner’s tumour) is an uncommon disorder that has recently been confirmed as an IgG4-related disease. Here, we describe a rare case of a 53-year-old male patient who primarily presented with pancreatic body mass, left neck mass and several lumps in his lower lip mimicking pancreatic cancer (PC) and neck metastasis. The patient underwent pancreatic body mass and labial gland lumps resection as well as an ultrasound-guided biopsy of the left neck mass. He was diagnosed with IgG4-related focal type of AIP (f-AIP) and Küttner’s tumour by immunohistochemistry. The patient responded well to corticosteroid therapy and remains healthy with no signs of recurrence at one year follow-up. The differentiation of f-AIP from PC is very important to avoid unnecessary pancreatic resection.

Keywords: IgG4-related disease; IgG4-related focal type of AIP; Küttner’s tumour; Autoimmune pancreatitis; Pancreatic cancer

Core tip: We report a rare case of 53-year-old male patient who suffered from IgG4-related focal type of autoimmune pancreatitis (f-AIP) accompanied with Küttner’s tumour originally suspected of being pancreatic cancer with neck metastasis. The patient responded well to corticosteroid therapy but he had undergone an unnecessary pancreatic body mass resection one year ago prior to admission. Therefore, we suggest that AIP should always be considered in case of a focal pancreatic mass.