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복막 암종증으로 진행한 자가면역성 췌장염 1예

Metachronous Development of Peritoneal Carcinomatosis in a Patient with Autoimmune Pancreatitis

대한소화기학회지 2020년 75권 6호 p.356 ~ 361
이규원 ( Lee Kyu-Won ) - Catholic University College of Medicine Department of Internal Medicine

장재혁 ( Chang Jae-Hyuck ) - Catholic University College of Medicine Department of Internal Medicine
김진아 ( Kim Jean-A ) - Catholic University College of Medicine Department of Pathology
김태호 ( Kim Tae-Ho ) - Catholic University College of Medicine Department of Internal Medicine
김창환 ( Kim Chang-Whan ) - Catholic University College of Medicine Department of Internal Medicine
김재광 ( Kim Jae-Kwang ) - Catholic University College of Medicine Department of Internal Medicine
한석원 ( Han Sok-Won ) - Catholic University College of Medicine Department of Internal Medicine

Abstract


Autoimmune pancreatitis (AIP) is a rare and unique type of chronic pancreatitis. The prognosis of AIP, particularly when associated with pancreatic cancer or a related malignancy, is not known. Only a few cases, where metachronous pancreas-related cancer developed during follow-up, have been reported. Most of these patients either underwent surgery or steroid therapy. This paper reports a case of a 66-year-old woman with untreated type I AIP who developed peritoneal carcinomatosis more than 2 years later. Initially, the patient had a markedly elevated serum IgG4 level and a diffuse, infiltrative mass-like lesion in the pancreatic head, in which the biopsy results were consistent with type I AIP. The patient was not treated with steroids because of a cerebellar infarction. Twenty-eight months after the diagnosis of AIP, peritoneal carcinomatosis developed without noticeable changes in the pancreas from the initial findings.

키워드

Autoimmune pancreatitis; Immunoglobulin G4-related disease; Pancreatic neoplasms; Peritoneal neoplasms
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