Lin ZQ, Li X, Yang Y, Wang Y, Zhang XY, Zhang XX, Guo J. Nonfunctional pancreatic neuroendocrine tumours misdiagnosed as autoimmune pancreatitis: A case report and review of literature. World J Clin Cases 2022; 10(15): 4886-4894 [PMID: 35801029 DOI: 10.12998/wjcc.v10.i15.4886]
Corresponding Author of This Article
Jia Guo, MD, PhD, Professor, Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. guojia4120@wchscu.cn
Research Domain of This Article
Health Care Sciences & Services
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 26, 2022; 10(15): 4886-4894 Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4886
Nonfunctional pancreatic neuroendocrine tumours misdiagnosed as autoimmune pancreatitis: A case report and review of literature
Zi-Qi Lin, Xin Li, Yan Yang, Yi Wang, Xiao-Ying Zhang, Xiao-Xin Zhang, Jia Guo
Zi-Qi Lin, Xin Li, Xiao-Ying Zhang, Xiao-Xin Zhang, Jia Guo, Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yan Yang, Laboratory Medicine, West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
Yi Wang, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Lin ZQ, Li X, Yang Y, Wang Y performed the experiments and image acquisition; Lin ZQ, Zhang XY, Zhang XX and Guo J designed the study and wrote the manuscript; Guo J edited the manuscript.
Supported byNational Natural Scientific Foundation of China, No. 8150341 to Lin ZQ, and No. 81873107 to Guo J.
Informed consent statement: This study was reviewed and approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University [No. 2021(407)]. The Patient was not required to provide informed consent because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia Guo, MD, PhD, Professor, Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. guojia4120@wchscu.cn
Received: September 19, 2021 Peer-review started: September 19, 2021 First decision: October 18, 2021 Revised: October 29, 2021 Accepted: April 3, 2022 Article in press: April 3, 2022 Published online: May 26, 2022 Processing time: 247 Days and 1.9 Hours
Abstract
BACKGROUND
Nonfunctional pancreatic neuroendocrine tumours are difficult to diagnose in the early stage of disease due to a lack of clinical symptoms, but they can rarely manifest as autoimmune pancreatitis. Autoimmune pancreatitis is an uncommon disease that may cause recurrent acute pancreatitis and is therefore often regarded as a special type of chronic pancreatitis.
CASE SUMMARY
We report a case of a 42-year-old female who had nonspecific upper abdominal pain for 4 years and radiological abnormalities of the pancreas that mimicked autoimmune pancreatitis. The symptoms and pancreatic imaging did not improve following 1 year of steroid therapy. Finally, pancreatic biopsy was performed through endoscopic ultrasonography-guided fine-needle aspiration biopsy, and nonfunctional pancreatic neuroendocrine tumours were ultimately diagnosed. Pancreatectomy has resolved her symptoms.
CONCLUSION
Therefore, the differentiation of nonfunctional pancreatic neuroendocrine tumours from autoimmune pancreatitis is very important, although it is rare. We propose that endoscopic ultrasonography-guided fine-needle aspiration biopsy should be performed if imaging characteristics are equivocal or the diagnosis is in question.
Core Tip: We report a case of a 42-year-old female patient who suffered from nonfunctional pancreatic neuroendocrine tumours but was misdiagnosed for 4 years. After the 3-year follow-up, she was misdiagnosed with autoimmune pancreatitis through radiography and underwent 1 year of corticosteroid therapy. However, her symptoms worsened. Biopsy via endoscopic ultrasonography-guided fine needle aspiration biopsy made a correct diagnosis of nonfunctional pancreatic neuroendocrine tumours, and pancreatectomy resolved the symptoms. Therefore, we propose that endoscopic ultrasonography-guided fine needle aspiration biopsy should be performed if imaging characteristics are equivocal or the diagnosis is in question.
