Pancreatic granulomatous necrotizing vasculitis: a case report and review of the literature.

This paper describes a 48-year-old woman admitted to surgical department with mid-epigastric pain. Ultrasonography of the abdomen and magnetic resonance imaging revealed an ipoechoic mass in the head of pancreas suggestive for malignant tumor. She underwent pancreaticoduodenectomy; histologic examination showed a granulomatous inflammation with necrosis and destruction of the wall of small-medium size blood vessels very suggestive for Wegener's granulomatosis (WG). No other visceral involvement was found; test for antineutrophil cytoplasmic antibodies was negative. Initial and symptomatic involvement of pancreas was reported in very few cases of WG.