Published online Dec 27, 2019. doi: 10.4240/wjgs.v11.i12.443
Peer-review started: August 23, 2019
First decision: September 13, 2019
Revised: September 18, 2019
Accepted: November 7, 2019
Article in press: November 7, 2019
Published online: December 27, 2019
IgG4-related disease can manifest diversely, including autoimmune pancreatitis and IgG4-related cholangiopathy. We are reporting a very unusual cause of pancreatic cancer triggered in a previously unknown IgG4-related disease.
A 75-year-old man was diagnosed with a 43 mm × 33 mm pancreatic head tumor after consulting for abdominal pain and jaundice. A pancreaticoduodenectomy was carried out uneventfully, and the histopathology report showed an early stage of acinar-cell pancreatic cancer. The patient reconsulted on the 30th postoperative day with fever, jaundice and asthenia. Magnetic resonance cholangiopancreatography evidenced an extense bile duct stricture. A percutaneous biliary drainage proved to be ineffective, even after exchanging it with larger bore drainage. Reviewing the surgical specimen, features compatible with IgG4-related disease were observed. Consequently, empiric treatment with steroids was initiated achieving excellent results.
IgG4-related disease may cause chronic inflammation of the pancreas and can condition pancreatic malignancies.
Core tip: Until today, the relationship between autoimmune pancreatitis and pancreatic cancer was not clear, and there are no studies in this regard. We are reporting a very unusual cause of pancreatic cancer triggered in a previously unknown IgG4-related disease and conducted an up-to-date literature review.