[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-380987-105":59,"doc-detail-380987-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","a-rare-pancreatic-tumor-mimicking-chronic-calcified-pancreatitis-case-report-and-endoscopic-management","A rare pancreatic tumor mimicking chronic calcified pancreatitis - Case report and endoscopic management","","A 48-year-old woman presented with severe upper abdominal pain and marked dilation of the main pancreatic duct filled with multiple high-density stones. She was initially diagnosed with chronic pancreatitis and treated with planned therapeutic ERCP. A 2-cm head duct stricture with purulent juice and numerous movable pancreatic stones was found, and a fully covered self-expandable metal stent with additional plastic stents enabled subsequent removal of dozens of stones. Recurrent symptoms led to repeat ERCP with peroral pancreatoscopy, revealing villous fish-egg-like ulcerated lesions; biopsy showed high-grade intraepithelial neoplasia, and surgery confirmed intraductal papillary mucinous neoplasm with regional canceration.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-rare-pancreatic-tumor-mimicking-chronic-calcified-pancreatitis-case-report-and-endoscopic-management/380987/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-rare-pancreatic-tumor-mimicking-chronic-calcified-pancreatitis-case-report-and-endoscopic-management/380987.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why did the tumor mimic chronic calcified pancreatitis in this case?","Question",{"text":113,"@type":114},"The main pancreatic duct stricture and radiographic appearance suggested chronic pancreatitis with stones, but peroral pancreatoscopy later showed characteristic villous, fish-egg-like ulcerated lesions consistent with intraductal pathology.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What role did the fully covered self-expandable metal stent play?",{"text":118,"@type":114},"The temporary placement of the fully covered metal stent across the severe duct stenosis made manipulation feasible, enabling removal of abundant pancreatic stones and assessment of the duct.",{"name":120,"@type":111,"acceptedAnswer":121},"How was the final diagnosis established?",{"text":122,"@type":114},"Biopsy from the lesion during peroral pancreatoscopy demonstrated high-grade intraepithelial neoplasia, and definitive surgical pathology confirmed intraductal papillary mucinous neoplasm with regional canceration.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},380987,1790742826,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Article published online: 2023-03-30  \nA rare pancreatic tumor mimicking chronic calcified pancreatitis  \n| |\n| --- |\n| ▶Fig. 1 Pancreatography showed a long stricture at the head of the pancreatic duct and significant upstream dilation with multiple filling defects. |\n| |\n| ▶Fig.2 A covered metal stent was placed across the pancreatic stricture, with additional plastic stents in both the biliary and pancreatic ducts. |\n\n▶Fig.3 After retrieving the stents, dozens of pancreatic stones were successfully removed.  \nVideo 1 A rare pancreatic tumor mimicking chronic calcified pancreatitis.  \nA 48-year-old woman was admitted for severe upper abdominal pain, with impressive dilation and multiple high-density stones in the main pancreatic duct (PD) . The patient was diagnosed with“chronic pancreatitis” and a therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was planned. A predominant stricture, 2cm long, was found at the head of the PD, with significant upstream dilation. Purulent juice and dozens of multiple movable stones up to 9mm in diameter were noted ( ▶ Fig.1) . A 10×60mm fully covered self-expandable metal stent (FCSEMS; Wallflex; Boston Scientific, Marlborough, Massachusetts, USA) was then deployed across the stricture, and plastic stents were placed in both the bile duct and PD ( ▶ Fig.2) . The patient returned for the second ERCP 3 weeks later. All the PD stones were successfully removed following the retrieval of the FCSEMS ( ▶ Fig.3) . One month after her discharge, the patient was readmitted due to recurrent epigastric pain. During the third ERCP, peroral pancreatoscopy (Spyglass DS; Boston Scientific) was performed. Many villous and fish-egg-like lesions were  \nfound at the stricture segment, with a fragile and ulcerated surface ( ▶Video 1) . No noticeable mucus was observed in the PD ( ▶ Fig.4) . The pathological examination of the biopsy revealed high grade intraepithelial neoplasia. The patient underwent pancreaticoduodenectomy, which was finally diagnosed as intraductal papillary mucinous neoplasm (IPMN) with regional canceration ( ▶ Fig.5) . She recovered uneventfully and remained tumor free to date.  \nIPMN generally has a long and hidden pathogenesis, and rarely includes pancreatic stone formation. This tumor usually produces much mucus, and sepsis infections are uncommon. The typical manifestations under Spyglass play an essential role in establishing the diagnosis [1,2] . However, severe PD stenosis makes the manipulation challenging. In this case, the temporary use of an FCSEMS made it possible to remove abundant stones and identify typical features. Although the investigative process was a bit prolonged, an accurate diagnosis was eventually obtained.  \nEndoscopy_UCTN_Code_CCL_ 1AZ_ 2AB  \nE592 Xia Mingxing, Hu Bing. A rare pancreatic… Endoscopy 2023; 55: E592–E593 | © 2023. The Author(s) .  \n▶Fig.4 Many villous and fish-egg-like lesions were found at the stricture segment, with a fragile and ulcerated surface.  \nCompeting interests  \nThe authors declare that they have no conflict of interest.  \nThe authors  \nMingxing Xia, Bing Hu   \nDepartment of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China  \n▶Fig.5 Pathology indicated intraductal papillary mucinous neoplasm with regional canceration.  \nCorresponding author  \nBing Hu, MD  \nDepartment of Gastroenterology and Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, 225 Changhai Road, Shanghai 200438, China [drhubing@aliyun.com](drhubing@aliyun.com)  \nReferences  \n[1] Tyberg A, Raijman I, Siddiqui A et al. Digital pancreaticocholangioscopy for mapping of pancreaticobiliary neoplasia: can we alter the surgical resection margin? J Clin Gastroenterol 2019; 53: 71–75  \n[2] Trindade AJ, Benias PC, Kurupathi P et al. Digital pancreatoscopy in the evaluation of main duct intraductal papillary mucinous neoplasm: a multicenter study. Endoscopy 2018; 50: 1095–1098  \nBibliography  \nEndosc","cbCaiasYCW5C0dVw","https://ap.wps.com/l/cbCaiasYCW5C0dVw","pdf",581847,"English","# Case presentation and initial ERCP\n## Stent placement and stone extraction\n# Recurrent symptoms and peroral pancreatoscopy\n## Biopsy findings and final diagnosis\n# Discussion and diagnostic value of Spyglass","[{\"question\":\"Why did the tumor mimic chronic calcified pancreatitis in this case?\",\"answer\":\"The main pancreatic duct stricture and radiographic appearance suggested chronic pancreatitis with stones, but peroral pancreatoscopy later showed characteristic villous, fish-egg-like ulcerated lesions consistent with intraductal pathology.\"},{\"question\":\"What role did the fully covered self-expandable metal stent play?\",\"answer\":\"The temporary placement of the fully covered metal stent across the severe duct stenosis made manipulation feasible, enabling removal of abundant pancreatic stones and assessment of the duct.\"},{\"question\":\"How was the final diagnosis established?\",\"answer\":\"Biopsy from the lesion during peroral pancreatoscopy demonstrated high-grade intraepithelial neoplasia, and definitive surgical pathology confirmed intraductal papillary mucinous neoplasm with regional canceration.\"}]","A rare pancreatic tumor mimicking chronic calcified pancreatitis - Case report and endoscopic management | PDF",1790243054]