DOI: 10.36347/sjams.2021.v09i10.001

Pages: 1489-1492

Pancreatic tuberculosis is very rare, but recently there has been an increase in the number of reports of pancreatic tuberculosis involvement. It closely mimics pancreatic cancer, and before the advent of better imaging modalities, it was often detected as a surprise histologic problem in patients resected for suspected pancreatic malignancy. The usual presentation includes abdominal pain, anorexia with loss of weight, jaundice which may be associated with cholestasis, fever and night sweats, a palpable abdominal mass and lymphadenopathy. Computed tomography (CT) of the abdomen is an important tool in the assessment of patients with pancreatic tuberculosis. This imaging gives valuable information on the size and nature of tuberculosis lesions as well as the presence of ascites and lymphadenopathy. However, there is no distinguishing feature that distinguishes it from pancreatic carcinoma. In this regard, we report a case of pancreatic tuberculosis in its pseudotumoral form, revealed during an etiological assessment of chronic abdominal pain in a 23-year-old girl who had type 1 diabetes on insulin for 5 years as ATCD. The diagnosis was confirmed by the demonstration of gigantocellular epithelioid granulomas centered by caseous necrosis on surgical biopsies of the pre-pancreatic peritoneum and lymphadenopathy. The outcome was clinically and radiologically favorable after initiation of anti-tuberculosis quadruple therapy.