title: Groove Pancreatitis, a Masquerading Yet Distinct Clinicopathological Entity: Analysis of Risk Factors and Differentiation.
abstract: OBJECTIVE
  Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP).
  
  
  METHODS
  A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions.
  
  
  RESULTS
  Thirteen patients with GP (mean ± SD age, 51.9 ± 10.5 years; 11 males [84.6%]), all with a history of smoking (mean, 37.54 ± 17.8 pack-years), were identified. Twelve patients (92.3%) had a history of heavy alcohol drinking (heavy alcohol [EtOH]). The mean lesion size was 2.6 ± 1.1 cm, and the CA 19-9 was elevated (>37 IU/mL) in 5 patients (45.5%). The most common histopathologic condition was duodenal wall cyst with myofibroblastic proliferation and changes of chronic pancreatitis in the HOP.Univariate analysis revealed decreasing age, male sex, weight loss, nausea/vomiting, heavy EtOH, smoking, and a history of chronic pancreatitis were predictive of GP. A multivariate analysis among smokers demonstrated that weight loss (P = 0.006; odds ratio, 11.96; 95% confidence interval, 2.1-70.2), and heavy EtOH (P < 0.001; odds ratio, 82.2; 95% confidence interval, 9.16-738.1) were most predictive of GP. Compared to pancreatic adenocarcinoma (n = 183), weight loss and heavy EtOH remained predictive of GP.
  
  
  CONCLUSIONS
  Groove pancreatitis in the HOP is associated with a history of heavy EtOH and weight loss. In the absence of these symptoms, it is essential to rule out a malignant lesion.
authors.affiliation: From the *Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, †Department of Surgery, and ‡Department of Pathology, The Ohio State University Wexner Medical Center; and §Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH.
authors.forename: Veeral M
authors.initials: VM
authors.lastname: Oza
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Skeans
authors.forename: Peter
authors.initials: P
authors.lastname: Muscarella
authors.forename: Jon P
authors.initials: JP
authors.lastname: Walker
authors.forename: Brett C
authors.initials: BC
authors.lastname: Sklaw
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Cronley
authors.forename: Samer
authors.initials: S
authors.lastname: El-Dika
authors.forename: Benjamin
authors.initials: B
authors.lastname: Swanson
authors.forename: Alice
authors.initials: A
authors.lastname: Hinton
authors.forename: Darwin L
authors.initials: DL
authors.lastname: Conwell
authors.forename: Somashekar G
authors.initials: SG
authors.lastname: Krishna
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D001706:Biopsy; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D050500:Pancreatitis, Chronic / Q000145:classification / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D009626:Terminology as Topic; D015431:Weight Loss