摘要
BACKGROUND IgG4-related disease can manifest diversely,including autoimmune pancreatitis and IgG4-related cholangiopathy.We are reporting a very unusual cause of pancreatic cancer triggered in a previously unknown IgG4-related disease.CASE SUMMARY A 75-year-old man was diagnosed with a 43 mm×33 mm pancreatic head tumor after consulting for abdominal pain and jaundice.A pancreaticoduodenectomy was carried out uneventfully,and the histopathology report showed an early stage of acinar-cell pancreatic cancer.The patient reconsulted on the 30th postoperative day with fever,jaundice and asthenia.Magnetic resonance cholangiopancreatography evidenced an extense bile duct stricture.A percutaneous biliary drainage proved to be ineffective,even after exchanging it with larger bore drainage.Reviewing the surgical specimen,features compatible with IgG4-related disease were observed.Consequently,empiric treatment with steroids was initiated achieving excellent results.CONCLUSION IgG4-related disease may cause chronic inflammation of the pancreas and can condition pancreatic malignancies.
BACKGROUND Ig G4-related disease can manifest diversely, including autoimmune pancreatitis and Ig G4-related cholangiopathy. We are reporting a very unusual cause of pancreatic cancer triggered in a previously unknown Ig G4-related disease.CASE SUMMARY A 75-year-old man was diagnosed with a 43 mm × 33 mm pancreatic head tumor after consulting for abdominal pain and jaundice. A pancreaticoduodenectomy was carried out uneventfully, and the histopathology report showed an early stage of acinar-cell pancreatic cancer. The patient reconsulted on the 30 th postoperative day with fever, jaundice and asthenia. Magnetic resonance cholangiopancreatography evidenced an extense bile duct stricture. A percutaneous biliary drainage proved to be ineffective, even after exchanging it with larger bore drainage. Reviewing the surgical specimen, features compatible with Ig G4-related disease were observed. Consequently, empiric treatment with steroids was initiated achieving excellent results.CONCLUSION Ig G4-related disease may cause chronic inflammation of the pancreas and can condition pancreatic malignancies.
