Patient diagnosed with immunoglobulin G4-related autoimmune pancreatitis after total pancreatoduodenectomy, gastrectomy, and splenectomy: A case report

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition involving the development of mass lesions of the affected organ, which can mimic many malignant disorders. IgG4-related autoimmune pancreatitis (AIP) is a common presentation form of IgG4-RD. Patients presenting with multiple mass lesions in the pancreas undergo aggressive surgeries with the misdiagnosis of pancreatic adenocarcinoma. A patient applied to the health center with back and stomach pain. She had two mass lesions involving the pancreatic head and tail; tumor markers were not significantly elevated. The patient underwent total pancreatoduodenectomy, total gastrectomy, and total splenectomy due to misdiagnosed pancreatic adenocarcinoma and developed severe morbidities afterward. She was diagnosed with IgG4-related AIP after surgery. On performing clinical suspicion the necessary diagnostic procedures for exclusion will protect patients from unnecessary surgeries that may lead to severe morbidities.

Keywords

• autoimmune pancreatitis; carcinoma; immunoglobulin g4-related disease; whipple operation