PSEUDOTUMOROUS PANCREATITIS -REPORT OF TWO CASES-

Abstract

Two cases of pseudotumorous pancreatitis which were difficult to differentiate from pancreatitis are reported together with some discussion. Case 1 was a 58-year-old man who admitted to our hospital complaining of jaundice. A tumor was found at the head of pancreas, and the common bile duct and pancreatic duct in the tail of pancreas dilated. Various imaging methods failed to differentiate from pancreatic cancer, cytology of bile juice resulted in class IIIb, pancreatoduodenectomy being performed. Case 2 was a 38-year-old man who was referred to our hospital by a near practitioner for a suspicion of pancreatic cancer. He was a heavy drinker and complained of epigastric and back pain. A tumor was found at the head of pancreas accompaning by jaundice, dilated pancreatic duct in the tail of pancreas being seen. It was difficult to distinguish from a pancreatic cancer, and pancreatoduodenectomy was performed.
Although there have been reported varied differentiating methods such as imaging diagnostic methods and blood biochemical examinations including tumor markers, no definite has been established as yet. Most potent clue for pseudotumorous pancreatitis may lie in that the tumors often diminish. However, we do not know the period neccessary for observation of the clinical course, and besides, prognosis of pancreatic cancer is extremely poor, in that we should not hesitate to undertake surgery.