A rare case of adenocarcinoma in the accessory duct of the pancreas differential diagnosis from groove pancreatitis

Abstract

A 69 year-old man was admitted to our hospital because of epigastralgia and vomiting. An upper GI examination revealed severe stenosis in the 2nd portion of the duodenum, whereas the endoscopic examination showed an almost normal mucosa. Ultrasonography, computed tomography and MR cholangio-pancreatography showed a tumor in the pancreas head, but no dilatation of the main pancreatic duct or common bile duct. A diagnosis of groove pancreatitis was made, although it was difficult to distinguish from pancreatic cancer. We started conservative therapy while the examinations were continued. Since the therapy was ineffective and the PET strongly suggested pancreatic cancer, a pancreaticoduodenectomy was performed. Pathological examination showed adenocarcinoma derived from the accessory duct of the pancreas.