A suspicious pancreatic mass in chronic pancreatitis: pancreatic actinomycosis.

Autor: de Clerck F; Department of Gastroenterology and Hepatology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium., Laukens P; Department of Gastroenterology and Hepatology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium., De Wilde V; Department of Gastroenterology and Hepatology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium., Vandeputte L; Department of Gastroenterology and Hepatology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium., Cabooter M; Department of Gastroenterology and Hepatology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium., Van Huysse J; Department of Pathology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium., Orlent H; Department of Gastroenterology and Hepatology, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium.
Jazyk: angličtina
Zdroj: Case reports in oncological medicine [Case Rep Oncol Med] 2015; Vol. 2015, pp. 767365. Date of Electronic Publication: 2015 Feb 03.
DOI: 10.1155/2015/767365
Abstrakt: Introduction. Pancreatic actinomycosis is a chronic infection of the pancreas caused by the suppurative Gram-positive bacterium Actinomyces. It has mostly been described in patients following repeated main pancreatic duct stenting in the context of chronic pancreatitis or following pancreatic surgery. This type of pancreatitis is often erroneously interpreted as pancreatic malignancy due to the specific invasive characteristics of Actinomyces. Case. A 64-year-old male with a history of chronic pancreatitis and repeated main pancreatic duct stenting presented with weight loss, fever, night sweats, and abdominal pain. CT imaging revealed a mass in the pancreatic tail, invading the surrounding tissue and resulting in splenic vein thrombosis. Resectable pancreatic cancer was suspected, and pancreatic tail resection was performed. Postoperative findings revealed pancreatic actinomycosis instead of neoplasia. Conclusion. Pancreatic actinomycosis is a rare type of infectious pancreatitis that should be included in the differential diagnosis when a pancreatic mass is discovered in a patient with chronic pancreatitis and prior main pancreatic duct stenting. Our case emphasizes the importance of pursuing a histomorphological confirmation.
Databáze: MEDLINE