Tumor-forming type of pancreatitis always has a problem of diagnostic difficulty in differenciating from pancreatic cancer. This paper describes a case of duodenal stenosis due to tumor-forming type of pancreatitis as well as a discussion of differential diagnosis between pancreatic cancer and pancreatitis.
A 49 year-old man was admitted to receive close examination for a mass of the pancreatic head and duodenal stenosis occuring after an attack of acute pancreatitis. Ultrasonogram showed an enlarged pancreatic head with unclearly demarcated margin. Computed tomography (CT) revealed a mass involving the head of the pancreas and infiltrating into the duodenum, strongly suggeting a carcinoma. Angiography did not reveal an encasement and other abnormal findings.
These preoperative examinations suggested carcinoma, so pancreaticoduodenectomy was performed. In the resected specimen, a tumor with a size of 5×4×2cm was found in the pancreatic head, just adjacent to the duodenum. Histologic sections showed severe fibrosis of the pancreas with an infiltration of many inflammatory cells, thus it means chronic pancreatitis locally.
It could be concluded that the differental diagnosis between tumor-forming type of pancreatits and pancreatic cancer was very difficult.