An 80-year-old woman with epigastric pain and loss of consciousness for five months was admitted with no previous history of infections or pancreatic diseases.
Physical examination was unremarkable.
Analytically: bilirubin 0.7 mg/dl, amylase 80 U/l, C-reactive protein 6.7 mg/l, transaminase and normal tumor markers.
Gastroscopy was normal.
Computed tomography (CT) showed a pancreatic head lesion suggestive of adenocarcinoma.
Contrast enhanced endoscopy showed a heterogeneous area not suggestive of adenocarcinoma.
Needle aspiration cytology (FNAC) showed no malignant cells.
Discordance of the tests and high surgical risk, PET-CT was performed to establish the diagnosis.
He showed a hypermetabolic nodule suggestive of malignancy.
A CT-guided lesion biopsy (Tru-Cut) showed granulomatous pancreatitis.
For this reason a conservative attitude was maintained and after six months the control CT showed no changes.
