Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4886
Peer-review started: September 19, 2021
First decision: October 18, 2021
Revised: October 29, 2021
Accepted: April 3, 2022
Article in press: April 3, 2022
Published online: May 26, 2022
Nonfunctional pancreatic neuroendocrine tumours are difficult to diagnose in the early stage of disease due to a lack of clinical symptoms, but they can rarely manifest as autoimmune pancreatitis. Autoimmune pancreatitis is an uncommon disease that may cause recurrent acute pancreatitis and is therefore often regarded as a special type of chronic pancreatitis.
We report a case of a 42-year-old female who had nonspecific upper abdominal pain for 4 years and radiological abnormalities of the pancreas that mimicked autoimmune pancreatitis. The symptoms and pancreatic imaging did not improve following 1 year of steroid therapy. Finally, pancreatic biopsy was performed through endoscopic ultrasonography-guided fine-needle aspiration biopsy, and nonfunctional pancreatic neuroendocrine tumours were ultimately diagnosed. Pancreatectomy has resolved her symptoms.
Therefore, the differentiation of nonfunctional pancreatic neuroendocrine tumours from autoimmune pancreatitis is very important, although it is rare. We propose that endoscopic ultrasonography-guided fine-needle aspiration biopsy should be performed if imaging characteristics are equivocal or the diagnosis is in question.
Core Tip: We report a case of a 42-year-old female patient who suffered from nonfunctional pancreatic neuroendocrine tumours but was misdiagnosed for 4 years. After the 3-year follow-up, she was misdiagnosed with autoimmune pancreatitis through radiography and underwent 1 year of corticosteroid therapy. However, her symptoms worsened. Biopsy via endoscopic ultrasonography-guided fine needle aspiration biopsy made a correct diagnosis of nonfunctional pancreatic neuroendocrine tumours, and pancreatectomy resolved the symptoms. Therefore, we propose that endoscopic ultrasonography-guided fine needle aspiration biopsy should be performed if imaging characteristics are equivocal or the diagnosis is in question.