Diagnostic challenges of pancreatic carcinoma presenting as acute pancreatitis - A case series and literature review

Sep 29, 2026

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Pancreatic cancer diagnosis is difficult when clinical features resemble acute pancreatitis, and misdiagnosis can postpone definitive therapy and worsen outcomes. This case series reviews pancreatic-related procedures at a tertiary hospital in Taiwan from 2011 to 2024 and identifies 70 resectable cases, including 18 initially diagnosed as pancreatitis. Four cases are presented to show how subtle malignancy signs may be hidden on early imaging. Careful imaging review and strong suspicion in recurrent pancreatitis are emphasized.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Keywords

1. INTRODUCTION

2. METHODS

2.1. Patients

J Chin MedAssoc Original article Diagnostic challenges of pancreatic carcinoma presenting as acute pancreatitis: A case series and literature review Chih-Kai Huanga, Hsuan-Hung Yua, Ching-Ming Kwoka, Ming-Zhang Sunga, Ming-Hsun Yanga, Chuan-Hsun Changb, Chi-Ming Liua, Gar-Yang Chauc,d,e, Cheng-Hsi Sua,* aDivision of General Surgery, Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan, ROC; bDivision of General Surgery, Breast Surgery, Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan, ROC; cInstitute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dDivision of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; eSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC Abstract Background: Pancreatic cancer can be challenging to diagnose, particularly when it presents with features resembling pancreatitis. Misdiagnosis can delay treatment and adversely affect patient outcomes. This case series highlights the diagnostic difficulties and clinical outcomes in patients initially diagnosed with pancreatitis, who were later found to have pancreatic malignancies such as pancreatic ductal adenocarcinoma (PDAC) . Methods: We reviewed the medical records of patients who underwent pancreatic-related procedures from 2011 to 2024 at a tertiary care hospital in Taiwan. Results: The review identified 70 patients with resectable pancreatic malignancies, of whom 18 (26%) had a diagnosis of pancreatitis before their cancer was diagnosed. Four cases were selected for detailed presentation, highlighting the potential for missed or delayed pancreatic cancer diagnoses in patients with recurrent pancreatitis. Upon further investigation, we found that subtle signs of malignancy are often masked on initial imaging studies, leading to delays in definitive diagnosis and treatment. Conclusion: This case series demonstrates the complexities in diagnosing pancreatic cancer, particularly when the presentation is that of pancreatitis. Our findings emphasize the need for careful review of imaging results and a high clinical suspicion of malignancy in patients with recurrent pancreatitis. Further research into more effective diagnostic tools and treatment strategies is warranted to enhance the early detection and management of pancreatic cancer in similar clinical scenarios. Keywords: Diagnosis; Pancreatic cancer; Pancreatitis [www.ejcma.org](www.ejcma.org) 701 Huang et al. J Chin MedAssoc Lay Summary: This study explores the challenges in diagnosing pancreatic cancer when it presents with symptoms similar to acute pancreatitis, a condition where the pancreas becomes inflamed. Pancreatic cancer is difficult to detect early, and its symptoms often overlap with those of acute pancreatitis, such as abdominal pain and elevated pancreatic enzymes. The study highlights four cases where patients were initially misdiagnosed with pancreatitis, leading to delays in diagnosing the underlying cancer. The cases demonstrate how imaging studies can be misleading due to the inflammation caused by pancreatitis, which can hide signs of cancer. The authors emphasize the importance of keeping a high level of suspicion for cancer in patients with unusual or recurrent episodes of pancreatitis, as timely diagnosis is crucial for better treatment outcomes. The study suggests that careful and repeated imaging, alongside thorough clinical evaluation, is necessary to avoid missing a cancer diagnosis. 1. INTRODUCTION Pancreatic cancer is an aggressive malignancy with a poor prognosis, often due to diagnosis when the disease is at an advanced stage.1 Early symptoms are typically vague and nonspecific, leading to delays in detection. Diagnosis relies heavily on imaging studies such as contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography (MRCP) to assess tumor

FAQs

Why can pancreatic carcinoma be hard to diagnose when it presents as acute pancreatitis?

Because symptoms and imaging findings may overlap with pancreatitis, and inflammatory changes can obscure underlying malignancy signals on initial studies.

What time span and setting does the study review?

The authors reviewed medical records of patients who underwent pancreatic-related procedures from 2011 to 2024 at a tertiary care hospital in Taiwan.

How many patients were initially diagnosed with pancreatitis before their cancer was identified?

Eighteen of 70 resectable pancreatic malignancy cases (26%) had a diagnosis of pancreatitis before the cancer was diagnosed.

Sep 29, 2026

Uploaded by Himbo