Published online Mar 16, 2015. doi: 10.4253/wjge.v7.i3.258
Peer-review started: August 28, 2014
First decision: September 30, 2014
Revised: November 15, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: March 16, 2015
Chronic pancreatitis increases the risk of developing pancreatic cancer. This often presents as a mass lesion in the head of pancreas. Mass lesion in the head of pancreas can also occur secondary to an inflammatory lesion. Recognising this is crucial to avoid unnecessary surgery. This is sometimes difficult as there is an overlap in clinical presentation and conventional computed tomography (CT) abdomen findings in inflammatory and malignant mass. Advances in imaging technologies like endoscopic ultrasound in conjunction with techniques like fine needle aspiration, contrast enhancement and elastography as well as multidetector row CT, magnetic resonance imaging and positron emission tomography scanning have been shown to help in distinguishing inflammatory and malignant mass. Research is ongoing to develop molecular techniques to help characterise focal pancreatic mass lesions. This paper reviews the current status of imaging and molecular techniques in differentiating a benign mass lesion in chronic pancreatitis and from malignancy.
Core tip: Evaluating head mass in chronic pancreatitis is clinically challenging. Advances in pancreatic imaging including endoscopic ultrasonography and molecular tools have been reviewed.