ArticleFrontiers in medicine2026
IgG4-related autoimmune pancreatitis mimicking pancreatic carcinoma: a case report.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A 59-year-old woman presented with a 5-month history of an incidentally discovered pancreatic mass and episodic epigastric pain. Imaging studies revealed a mass in the pancreatic head/neck and tail with suspected vascular encasement, and the tumor marker CA19-9 was markedly elevated. Due to these findings, pancreatic malignancy was initially suspected. However, serum IgG4 was found to be extremely elevated at 10,022 μg/mL, and an ultrasound-guided pancreatic biopsy showed benign ductal epithelium with low proliferative activity and occasional plasmacytoid cells, with no evidence of adenocarcinoma. A diagnosis of IgG4-related autoimmune pancreatitis was established. The patient was started on oral methylprednisolone (32 mg/day) and pancreatic enzyme supplements. Over 1 year of follow-up, her serum IgG4 level normalized to 489 μg/mL, CA19-9 returned to 16 U/mL, and serial MRI examinations demonstrated marked resolution of the pancreatic head/neck mass and improvement of the biliary stricture. This case underscores the clinical importance of including IgG4-AIP in the differential diagnosis of pancreatic masses, particularly when serologic or imaging features are equivocal, to prevent unnecessary surgical intervention.
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