A Case Report of Eosinophilic Pancreatitis presenting as Inflammatory Pancreatic Tumor

Yasuo Yasuoka, Atsushi Yoshida, Tooru Nakajyou, Taizou Yamamoto and Yasuhito Abe*

Department of Surgery, Saiseikai Matsuyama Hospital
Department of Molecular Pathology, Graduate School of Medicine, Ehime University*

A 69-year-old man admitted for high fever and epigastralgia was found in abdominal ultrasonography (US) to have a cystic tumor at the tail of the pancreas. He recovered in conservative therapy using several antibiotics. Endoscopic retrograde pancreatography (ERP) showed mild deformity of the main pancreatic duct, but no abnormal findings for the papilla of Vater and no evidence of eosinophilic gastroenterocolitis in biopsy specimens of gastric and duodenal mucosa. Tumor marker serum levels were normal and no abnormal findings were seen in angiography examination. His case was diagnosed as inflammatory pancreatic tumor accompanied by chronic pancreatitis, and he was treated using several antibiotics, recovered in three weeks. Six months later, he was readmitted for recurrent pancreatic tumor, and treated again using antibiotics, but the cystic lesion at the pancreas tail remained in abdominal computed tomography. Because the existence of a malignant neoplasm could not be excluded, we conducted distal pancreatectomy with splenectomy. Histological findings for the pancreatic tumor showed marked eosinophilic infiltration of the parenchyma around the pseudocyst formation with fibrosis. The definitive diagnosis was eosinophilic pancreatitis. Twelve months post operatively, abdominal CT showed cystic lesion at the body of the pancreas, so he was treated using oral suplatast tosilate, after which the latest tumor was no longer detected in abdominal CT, and he has done well since.

Key words
eosinophilic pancreatitis, inflammatory pancreatic tumor

Reprint requests
Yasuo Yasuoka Department of Surgery, Saiseikai Matsuyama Hospital
880-2 Yamanishi, Matsuyama, 791-8026 JAPAN

Accepted
May 21, 2008

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