title: Sarcoidosis of the pancreas mimicking adenocarcinoma.
abstract: Primary sarcoidosis of the pancreas is extremely rare. Clinical presentation is often identical to that of pancreatic adenocarcinoma. Preoperative diagnosis of primary pancreatic sarcoidosis is always challenging. We present a 52-year-old man who developed weight loss and obstructive jaundice. Abdomino-pelvic CT scan showed a mass in the pancreatic head. After hepatopancreaticobiliary MDT discussion, a Whipple's procedure was attempted but the mass was deemed unresectable due to invasion of the superior mesenteric vein. Upon completion of palliative chemotherapy, repeat imaging showed significant mass shrinkage. A reattempt Whipple's procedure was successfully undertaken. Histology showed changes of chronic pancreatitis and peripancreatic granulomatous inflammation with no evidence of malignancy and a diagnosis of sarcoidosis was made. Owing to the devastating nature of pancreatic adenocarcinoma, any mass in the pancreas must be thoroughly investigated before a definitive diagnosis is made.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Mater Hospital, Belfast, UK. alistairmayne@hotmail.co.uk
authors.forename: Alistair Ivan William
authors.initials: AI
authors.lastname: Mayne
authors.forename: Jawad
authors.initials: J
authors.lastname: Ahmad
authors.forename: Maurice
authors.initials: M
authors.lastname: Loughrey
authors.forename: Mark A
authors.initials: MA
authors.lastname: Taylor
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012507:Sarcoidosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D014057:Tomography, X-Ray Computed