ArticleFrontiers in medicine2026
Case Report: IgG4-related autoimmune pancreatitis presenting as an infiltrative cystic-solid pancreatic mass: lessons from a diagnostic pitfall.
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
IgG4-related autoimmune pancreatitis (AIP) can resemble pancreatic ductal adenocarcinoma (PDAC), but it typically presents as a solid mass rather than a cystic-solid lesion. We report a rare case of AIP in a middle-aged man with a long-standing pancreatic tail mass that gradually enlarged and developed a cystic-solid configuration. Photon-counting CT showed a non-enhancing cystic component and a progressively enhancing solid portion with apparent invasion of adjacent organs, while FDG-PET/CT demonstrated marked metabolic activity, all strongly suggestive of malignancy. Serum IgG4 levels were normal and no extrapancreatic IgG4-related involvement was present. The patient declined biopsy and underwent radical surgery; histopathology revealed dense fibrosis, pancreatic atrophy, and lymphoplasmacytic infiltration consistent with IgG4-related AIP, with no evidence of cancer. This case highlights that atypical cystic-solid AIP can closely mimic invasive PDAC even with advanced imaging techniques, underscoring the importance of recognizing such rare presentations to avoid unnecessary radical resection.
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