2016 Volume 49 Issue 11 Pages 1117-1123
A 74-year-old male patient had an irregular pancreatic mass twenty months after pancreaticoduodenectomy for carcinoma of the ampulla of Vater. He had a history of administration of adjuvant chemotherapy by gemcitabine for seven months and methotrexate for rheumatouid arthiritis, postoperative ileus, poorly controlled diabetes mellitus. He received total pancreatectomy under a diagnosis of the remnant pancreatic cancer based on imaging modalities. However, histopathological examination disclosed actinomycosis of the pancreas without any evidence of recurrent cancer. He was put on oral ampicillin intake for six months and he has been free from relapse for forty months. In this case, aggravated bacterial regurgitation into the pancreatic duct by ileus and increased susceptibility to infection caused by chemotherapy and diabetes are risk factors for developing actinomycosis.
