Pancreatic Carcinoma Masquerading as Groove Pancreatitis: Case Report and Review of Literature

  • Deep J Malde The HPB Unit; St James University Hospital; Beckett Street; Leeds LS9 7TF; United Kingdom Phone: +44-7958107942 Fax: +44-161.272.6064
  • Melissa Oliveira-Cunha
  • Andrew Malvern Smith
Keywords: Pancreatic Neoplasms, Pancreatitis


Context Groove pancreatitis is a distinct form of chronic pancreatitis affecting the space surrounded by the pancreatic head, duodenum and common bile duct. It is an uncommon pancreatic disease with challenging imaging diagnosis that can lead to surgical dilemmas. The purpose of this study is to report a case and review the current clinical, radiological and pathological characteristics of groove pancreatic carcinoma and groove pancreatitis. Case report A 58-year-old man, with a history of alcohol excess, presented with a 4 month history of upper abdominal pain associated with weight loss and vomiting. Failed duodenal dilatation led to gastroenterostomy with biopsies showing chronic inflammation. Further presentation with jaundice and pancreatic groove mass led to a Whipple’s pancreaticoduodenectomy. Histopathology report demonstrated cystic areas in both medial and lateral walls of his duodenum microscopically consistent with groove pancreatitis and a moderate to poorly differentiated adenocarcinoma. Conclusion Several studies have been attempted to clarify the points of differentiation between carcinoma and pancreatitis in the groove area. This discrimination has been proved to be difficult; frequently the definitive diagnosis is only obtained after surgical intervention. This condition should be considered when making the differential diagnosis in pancreatic groove pathology and duodenal stenosis.


Download data is not yet available.


Adsay NV, Zamboni G. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying ''cystic dystrophy of heterotopic pancreas'', ''para-duodenal wall cyst'', and ''groove pancreatitis''. Semin Diagn Pathol 2004; 21:247-54. [PMID 16273943]

Kloppel G. Chronic pancreatitis, pseudotumors and other tumor-like lesions. Mod Pathol 2007; 20(Suppl. 1):S113-31. [PMID 17486047]

Fléjou JF, Potet F, Molas G, Bernades P, Amouyal P, Fékété F. Cystic dystrophy of the gastric and duodenal wall developing in heterotopic pancreas: an unrecognised entity. Gut 1993; 34:343-7. [PMID 8097180]

Parc R, Soprani A, Louvel A. Heterotopic cystic pancreas of the duodenal wall without associated chronic pancreatitis. J Chir (Paris) 1977; 114:185-92. [PMID 925106]

McFaul CD, Vitone LJ, Campbell F, Azadeh B, Hughes ML, Garvey CJ, et al. Pancreatic hamartoma. Pancreatology 2004; 4:533-7. [PMID 15340246]

Becker V. Bauchspeicheldruse (Inselapperat ausgenommen). In: Doerr W, ed. Spezielle pathologische Anatomie. Berlin, Germany: Springer, 1973.

Gabata T, Kadoya M, Terayama N, Sanada J, Kobayashi S, Matsui O. Groove pancreatic carcinomas: radiological and pathological findings. Eur Radiol 2003; 13:1679-84. [PMID 12835985]

Tan CH, Chow PK, Thng CH, Chung AY, Wong WK. Pancreatic adenocarcinoma that mimics groove pancreatitis: case report of a diagnostic dilemma. Dig Dis Sci 2006; 51:1294-6. [PMID 16944029]

Badia Bartolome C, Diaz Formoso FJ, Rodriguez Falcon R, Marchena Gomez J. Groove pancreatitis and its differential diagnosis with pancreatic adenocarcinoma. Gastroenterol Hepatol 2009; 32:22-8. [PMID 19174095]

Aimoto T, Uchida E, Nakamura Y, Katsuni A, Chou K, Kawamoto M, et al. Clinicopathologic study on pancreatic groove carcinoma. Pancreas 2006; 33:255-9. [PMID 17003647]

Ishigami K, Tajima T, Nishie A, Kakihara D, Fujita N, Asayama Y, et al. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: Usefulness of the portal venous phase. Eur J Radiol 2010; 74:e95-100. [PMID 19450943]

Itoh S, Yamakawa K, Shimamoto K, Endo T, Ishigaki T. CT findings in groove pancreatitis: correlation with histopathological findings. J Comput Assist Tomogr 1994;18:911-5. [PMID 7962798]

Becker V, Mischke U. Groove pancreatitis. Int J Pancreatol 1991; 10:173-82. [PMID 1787332]

Stolte M, Weiss W, Volkholz H, Rosch W. A special form of segmental pancreatitis: ''groove pancreatitis''. Hepato¬gastroenterology 1982; 29:198-208. [PMID 7173808]

Balakrishnan V, Chatni S, Radhakrishnan L, Narayanan VA, Nair P. Groove pancreatitis: a case report and review of literature. JOP. J Pancreas (Online) 2007; 8:592-7. [PMID 17873465]

Triantopoulou C, Dervenis C, Giannakou N, Papailiou J, Prassopoulos P. Groove pancreatitis: a diagnostic challenge. Eur Radiol 2009; 19:1736-43. [PMID 19238393]

Sanada Y, Yoshida K, Itoh H, Kunita S, Jinushi K, Matsuura H. Groove pancreatitis associated with true pancreatic cyst. J Hepatobiliary Pancreat Surg 2007;14:401-9. [PMID 17653641]

Shudo R, Yazaki Y, Sakurai S, Uenishi H, Yamada H, Sugawara K, et al. Groove pancreatitis: report of a case and review of the clinical and radiologic features of groove pancreatitis reported in Japan. Intern Med Jul 2002; 41:537-42. [PMID 12132521]

Mohl W, Hero-Gross R, Feifel G, Kramann B, Puschel W, Menges M, et al. Groove pancreatitis: an important differential diagnosis to malignant stenosis of the duodenum. Dig Dis Sci 2001; 46:1034-8. [PMID 11341646]

Rahman SH, Verbeke CS, Gomez D, McMahon MJ, Menon KV. Pancreatico-duodenectomy for complicated groove pancreatitis. HPB (Oxford) 2007; 9:229-34. [PMID 18333228]

Coronal CT with arrow illustrating deleted cystic changes of duodenal wall and intra and extra hepatic dilatation
How to Cite
MaldeD., Oliveira-CunhaM., & SmithA. (2011). Pancreatic Carcinoma Masquerading as Groove Pancreatitis: Case Report and Review of Literature. JOP. Journal of the Pancreas, 12(6), 598-602.