Diffuse-Type Pancreatic Ductal Adenocarcinoma Mimicking Autoimmune Pancreatitis

Pancreatic ductal adenocarcinoma (PDAC) classically presents as a solitary mass on cross-sectional imaging. Diffuse-type PDAC is an unusual variant that accounts for 1%–5% of PDACs. Owing to its rarity, there are no established radiographic or endosonographic definitions. We report a unique case of diffuse-type PDAC presenting with imaging findings of 2 distinct masses in the pancreatic head and tail and with endoscopic ultrasound findings of diffuse gland enlargement mimicking autoimmune pancreatitis. The case illustrates the importance of sampling several areas of the pancreas when diffuse enlargement is present on endoscopic ultrasound and multiple masses are seen on cross-sectional imaging.