Abdominal Sarcoidosis Mimicking Pancreatic Adenocarcinoma

Abstract

Sarcoidosis is a chronic, granulomatous, autoinflammatory disease that affects different parts of the body. Pulmonary manifestations are described in the majority of cases, with pancreatic involvement being <1-5%. The initial reports of pancreatic sarcoidosis were detected on autopsy. A review of the literature revealed that the majority of patients with pancreatic sarcoidosis initially presented with a clinical presentation identical to pancreatic malignancy. We describe the case of a male with a history of chronic pancreatitis and alcoholism who underwent pancreaticoduodenectomy given the concern for pancreatic denocarcinoma, and was found to have isolated pancreatic sarcoidosis. This case illustrates the difficulty in diagnosing the etiology of pancreatic masses pre-operatively leading to the majority of cases getting definitive diagnosis after operative exploration. We suggest that there needs to be further delineation of this disease process in order to determine the best treatment options for patients presenting with pancreatic disease.