Groove pancreatitis, a masquerading yet distinct clinicopathological entity: Analysis of risk factors and differentiation

Veeral M. Oza, Jacob M. Skeans, Peter Muscarella, Jon P. Walker, Brett C. Sklaw, Kevin M. Cronley, Samer El-Dika, Benjamin Swanson, Alice Hinton, Darwin L. Conwell, Somashekar G. Krishna

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objectives Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP). Methods A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions. Results 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. Conclusion 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.

Original languageEnglish (US)
Pages (from-to)901-908
Number of pages8
JournalPancreas
Volume44
Issue number6
DOIs
StatePublished - Aug 25 2015
Externally publishedYes

Keywords

  • Abbreviations
  • CI - confidence interval
  • CP - chronic pancreatitis
  • CT - computed tomography
  • EUS - endoscopic ultrasound
  • FCS - fully conditional specification
  • FNA - fine needle aspiration
  • GP - groove pancreatitis
  • HOP - head of pancreas
  • OR - odds ratio
  • chronic pancreatitis
  • groove pancreatitis
  • pancreatic malignancy
  • pancreaticoduodenal

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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    Oza, V. M., Skeans, J. M., Muscarella, P., Walker, J. P., Sklaw, B. C., Cronley, K. M., El-Dika, S., Swanson, B., Hinton, A., Conwell, D. L., & Krishna, S. G. (2015). Groove pancreatitis, a masquerading yet distinct clinicopathological entity: Analysis of risk factors and differentiation. Pancreas, 44(6), 901-908. https://doi.org/10.1097/MPA.0000000000000351