title: Follow-up of patients with pseudotumoral chronic pancreatitis: outcome and surveillance.
abstract: OBJECTIVE
  To follow up patients with pseudotumoral chronic pancreatitis (PCP) to assess their outcome and identify an optimal surveillance interval.
  
  
  METHODS
  Data obtained prospectively were analyzed in a retrospective manner. Patients with clinical evidence of chronic pancreatitis (abdominal pain in the epigastrium, steatorrhea, and diabetes mellitus), endoscopic ultrasound (EUS) criteria > 4, and EUS-fine needle aspiration (FNA) were included. A pseudotumor was defined as a non-neoplastic space-occupying lesion, a cause of chronic pancreatitis that may mimic changes typical of pancreatic cancer on CT or endoscopic ultrasound but without histological evidence. A real tumor was defined as a neoplastic space-occupying lesion because of pancreatic cancer confirmed by histology.
  
  
  RESULTS
  Thirty-five patients with chronic pancreatitis were included, 26 (74.2%) of whom were men. Nine (25.7%) patients were diagnosed with pseudotumoral chronic pancreatitis and two (2/35; 5.7%) patients with pseudotumoral chronic pancreatitis were diagnosed with pancreatic cancer on follow-up. The time between the diagnosis of pseudotumoral chronic pancreatitis and pancreatic adenocarcinoma was 35 and 30 d in the two patients. Definitive diagnosis of pancreatic adenocarcinoma was made by surgery. In the remaining six patients with pseudotumoral chronic pancreatitis, the median of follow-up was 11 mo (range 1-22 mo) and they showed no evidence of malignancy on surveillance. In the follow-up of patients without pseudotumoral chronic pancreatitis but with chronic pancreatitis, none were diagnosed with pancreatic cancer. According to our data, older patients with chronic pancreatitis are at risk of pseudotumoral chronic pancreatitis.
  
  
  CONCLUSIONS
  According to characteristics of patient, detection of PCP should lead a surveillance program for pancreatic cancer with EUS-FNA in < 1 mo or directly to surgical resection.
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Félix Ignacio
authors.initials: FI
authors.lastname: Téllez-Ávila
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Villalobos-Garita
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Chan
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Jorge
authors.initials: J
authors.lastname: Hernández-Calleros
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Luis
authors.initials: L
authors.lastname: Uscanga
authors.affiliation: Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, CP 14000, México.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Ramírez-Luna
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006104:Granuloma, Plasma Cell / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Chronic pancreatitis; Endoscopic ultrasound; Pseudotumoral chronic pancreatitis; Surveillance