Pancreatitis Can Present Like Cancer: Lymphoplasmacytic Sclerosing Pancreatitis in a Patient with a History of Gastric Carcinoma

Autoimmune pancreatitis has been associated with many syndromes in the presence of increased immunoglobulin levels. IgG4 antibodies are elevated in the context of lymphoplasmacytic sclerosing pancreatitis associated with IgG4-related disease. We present the case of a 74-year-old man diagnosed with autoimmune pancreatitis on a cancer background. Awareness of this condition in the cancer patient is crucial for timely diagnosis. Infectious complications might have implications for the choice of immunosuppressant. LEARNING POINTS: Autoimmune pancreatitis can mimic pancreatic cancer, thus delaying diagnosis in patients with cancer. It is important to rule out malignancy and distinguish autoimmune pancreatitis from pancreatic cancer, but obtaining a sample of pancreatic tissue can be difficult. Steroids are the mainstay of initial treatment, but there is growing evidence for the use of other immunomodulators, such as rituximab, for induction and maintenance or as an option for patients at high risk of relapse.