Groove Pancreatitis, a Masquerading Yet Distinct Clinicopathological Entity Analysis of Risk Factors and Differentiation

Abstract

Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP).A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions.Thirteen patients with GP (mean ± SD age, 51.9 ± 10.5 years; 11 males [84.6%]), all with a history of smoking (mean, 37.54 ± 17.8 pack-years), were identified. Twelve patients (92.3%) had a history of heavy alcohol drinking (heavy alcohol [EtOH]). The mean lesion size was 2.6 ± 1.1 cm, and the CA 19-9 was elevated (>37 IU/mL) in 5 patients (45.5%). The most common histopathologic condition was duodenal wall cyst with myofibroblastic proliferation and changes of chronic pancreatitis in the HOP.Univariate analysis revealed decreasing age, male sex, weight loss, nausea/vomiting, heavy EtOH, smoking, and a history of chronic pancreatitis were predictive of GP. A multivariate analysis among smokers demonstrated that weight loss (P = 0.006; odds ratio, 11.96; 95% confidence interval, 2.1-70.2), and heavy EtOH (P < 0.001; odds ratio, 82.2; 95% confidence interval, 9.16-738.1) were most predictive of GP. Compared to pancreatic adenocarcinoma (n = 183), weight loss and heavy EtOH remained predictive of GP.Groove pancreatitis in the HOP is associated with a history of heavy EtOH and weight loss. In the absence of these symptoms, it is essential to rule out a malignant lesion.

View details for DOI 10.1097/MPA.0000000000000351

View details for Web of Science ID 000360628600008

View details for PubMedID 25899649