Sarcoidosis of the pancreas mimicking adenocarcinoma

BMJ Case Rep. 2013 Jun 19:2013:bcr2013009118. doi: 10.1136/bcr-2013-009118.

Abstract

Primary sarcoidosis of the pancreas is extremely rare. Clinical presentation is often identical to that of pancreatic adenocarcinoma. Preoperative diagnosis of primary pancreatic sarcoidosis is always challenging. We present a 52-year-old man who developed weight loss and obstructive jaundice. Abdomino-pelvic CT scan showed a mass in the pancreatic head. After hepatopancreaticobiliary MDT discussion, a Whipple's procedure was attempted but the mass was deemed unresectable due to invasion of the superior mesenteric vein. Upon completion of palliative chemotherapy, repeat imaging showed significant mass shrinkage. A reattempt Whipple's procedure was successfully undertaken. Histology showed changes of chronic pancreatitis and peripancreatic granulomatous inflammation with no evidence of malignancy and a diagnosis of sarcoidosis was made. Owing to the devastating nature of pancreatic adenocarcinoma, any mass in the pancreas must be thoroughly investigated before a definitive diagnosis is made.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / physiopathology
  • Adult
  • Aged
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Diseases / diagnosis*
  • Pancreatic Diseases / diagnostic imaging
  • Pancreatic Diseases / physiopathology
  • Pancreatic Diseases / therapy
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / physiopathology
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / diagnostic imaging
  • Sarcoidosis / physiopathology
  • Sarcoidosis / therapy
  • Tomography, X-Ray Computed