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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2018; 09(02): 088-091
DOI: 10.4103/jde.JDE_95_17
Case Report
Society of Gastrointestinal Endoscopy of India

Pancreatic Cancer Masked by Acute Pancreatitis as well as an Unusual Iatrogenic Complication

Surinder Singh Rana
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ujjwal Gorsi
1   Department of Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Pankaj Gupta
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ravi Sharma
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Rajender Basher
2   Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Lovneet Dhalaria
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Rajesh Gupta
3   Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
24. September 2019 (online)

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ABSTRACT

A 62‑year‑old female presented with abdominal pain and was diagnosed as acute on chronic pancreatitis based on elevated serum amylase and imaging findings. The pancreatic duct was dilated with abrupt cutoff at neck of pancreas, but no mass was visualized. Positron emission tomography‑computed tomography (PET‑CT) revealed a fluorodeoxyglucose (FDG) avid lesion in the neck of the pancreas but ultrasound (USG)‑guided fine‑needle aspiration (FNA) from the lesion revealed only inflammatory cells. Endoscopic ultrasound, done 2 days after USG‑guided FNA, revealed pseudoaneurysm (PA) in the neck of pancreas that was confirmed on CT angiography. The PA was occluded by USG‑guided percutaneous cyanoacrylate injection. As pain persisted, repeat PET CT was done which revealed FDG avidity around the cyanoacrylate cast as well in multiple small hypodense lesions in the right lobe of the liver. USG‑guided FNA from both the liver lesion as well as the periphery of the glue cast revealed features of adenocarcinoma. We herein report a case of pancreatic adenocarcinoma that presented as acute pancreatitis and got masked because of formation of PA consequent to USG‑guided FNA.

Keywords

Adenocarcinoma - endosonography - fine‑needle aspiration - pseudoaneurysm
 

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