Actinomycosis mimicking a pancreatic head neoplasm diagnosed by EUS-guided FNA

摘要

A solid pancreatic mass on radiological imaging is a concerningfinding. Although such lesions are worrisome for adenocarcinoma, other possibilities include neuroendocrinetumors, lymphoma, solid pseudopapillary tumor, and focal pancreatitis. Infections and inflammatory diseases involving the pancreas may resemble cancer on presentation, but are rare. EUS-FNA often provides a diagnosis, but a definite preoperative diagnosis is not achieved in all. Thus, many patients with suspicion for pancreatic cancer and a resectable-appearing mass on imaging will undergo surgery for presumed adenocarcinoma with or without prior EUS. We encountered an unusual case in which actinomycosis caused a mass in the head of the pancreas that resembled a solid tumor. Diagnosis was established with EUS-FNA, which obviated the need for subsequent surgical exploration.