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©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2009; 15(10): 1273-1275
Published online Mar 14, 2009. doi: 10.3748/wjg.15.1273
Published online Mar 14, 2009. doi: 10.3748/wjg.15.1273
Intraductal papillary mucinous neoplasm in chronic calcifying pancreatitis: Egg or hen?
Evangelos Kalaitzakis, Barbara Braden, Palak Trivedi, Yalda Sharifi, Roger Chapman, Department of Gastroenterology, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
Evangelos Kalaitzakis, Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
Author contributions: All the authors contributed to the idea conception, writing of manuscript, and approval of final manuscript.
Correspondence to: Evangelos Kalaitzakis, MD, PhD, Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden. evangelos.kalaitzakis@vgregion.se
Telephone: +46-31-3421000
Fax: +46-31-822152
Received: January 4, 2009
Revised: February 19, 2009
Accepted: February 26, 2009
Published online: March 14, 2009
Revised: February 19, 2009
Accepted: February 26, 2009
Published online: March 14, 2009
Abstract
Intraductal papillary mucinous neoplasm (IPMN) is an increasingly reported entity. Extensive pancreatic calcification is generally thought to be a sign of chronic pancreatitis, but it may occur simultaneously with IPMN leading to diagnostic difficulties. We report a case of a patient initially diagnosed with chronic calcifying pancreatitis who was later shown to have a malignant IPMN. This case illustrates potential pitfalls in the diagnosis of IPMN in the case of extensive pancreatic calcification as well as clues that may lead the clinician to suspecting the diagnosis. The possible mechanisms of the relation between pancreatic calcification and IPMN are also reviewed.
Keywords: Intraductal papillary mucinous neoplasm, Endoscopic ultrasound, Calcifying pancreatitis, Carcinoembryonic antigen, Endoscopic retrograde cholangiopancreatography