International journal of surgery case reports · 2020
Pancreatic sarcoidosis mimicking neoplasia: Case report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chedid Georges, Harb Jad Gerges, Noureldine Hussein A, Tayar Claude, Nasser Selim M, Sabbah Nada Abbas
Аннотация
INTRODUCTION: Although sarcoidosis rarely involves the pancreas, such involvement may mimic pancreatic cancer. We herein report a case of pancreatic sarcoidosis giving rise to a cancer-mimicking retention cyst, concomitant with a neuroendocrine adenoma.
PRESENTATION OF CASE: A 47-year-old Caucasian male presented to follow-up for a benign-appearing cyst of the tail of the pancreas, detected incidentally on CT scan done for a urinary stone in 2017. He had been asymptomatic since his last presentation. The lesion was found to have increased in size from 1 cm to 3 cm in greater diameter. Yet, a CT angiography showed no evidence of invasion of surrounding organs, vessels, or lymph nodes. The patient had previous medical history of treated sarcoidosis, hypertension, recurrent nephrolithiasis, and gout. Due to the size increment a neoplastic cystic lesion was considered and distal pancreatectomy was performed. Pathologic examination revealed a retention cyst associated with chronic pancreatitis and the presence of non-caseating granulomas consistent with sarcoidosis. In addition, a neuroendocrine adenoma, and an adjacent focus of pancreatic intraepithelial neoplasia-1 and 2 were noted.
DISCUSSION: Such presentations may be asymptomatic, as in this case, and a multidisciplinary workup is often required. Care must be taken to rule out pancreatic cancer. A possible relationship between pancreatic sarcoidosis and pancreatic cancer merits further study.
CONCLUSION: The diagnosis of pancreatic sarcoidosis is difficult, and conclusive diagnosis requires histopathologic assessment.
PRESENTATION OF CASE: A 47-year-old Caucasian male presented to follow-up for a benign-appearing cyst of the tail of the pancreas, detected incidentally on CT scan done for a urinary stone in 2017. He had been asymptomatic since his last presentation. The lesion was found to have increased in size from 1 cm to 3 cm in greater diameter. Yet, a CT angiography showed no evidence of invasion of surrounding organs, vessels, or lymph nodes. The patient had previous medical history of treated sarcoidosis, hypertension, recurrent nephrolithiasis, and gout. Due to the size increment a neoplastic cystic lesion was considered and distal pancreatectomy was performed. Pathologic examination revealed a retention cyst associated with chronic pancreatitis and the presence of non-caseating granulomas consistent with sarcoidosis. In addition, a neuroendocrine adenoma, and an adjacent focus of pancreatic intraepithelial neoplasia-1 and 2 were noted.
DISCUSSION: Such presentations may be asymptomatic, as in this case, and a multidisciplinary workup is often required. Care must be taken to rule out pancreatic cancer. A possible relationship between pancreatic sarcoidosis and pancreatic cancer merits further study.
CONCLUSION: The diagnosis of pancreatic sarcoidosis is difficult, and conclusive diagnosis requires histopathologic assessment.