{
  "abstract": "Background Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by enhancing antitumor immunity, but their use is associated with immune-related adverse events (irAEs), including pancreatitis. ICI-related pancreatitis (ICI-P) is a rare irAE and can present atypically, often mimicking pancreatic malignancy posing significant diagnostic challenges.Methods We present a case series of three melanoma patients treated with ICIs who developed ICI-P. Surveillance PET/CT in all cases revealed pancreatic lesions concerning for malignancy. Diagnostic workups included endoscopic ultrasound (EUS) with fine-needle aspiration (FNA), magnetic resonance cholangiopancreatography (MRCP), and surgical pathology.Results In all three patients, PET/CT showed new focal hypermetabolism in pancreas for which MRCP reported concerning findings of pancreatic malignancy ( table 1). All underwent EUS guided FNA which showed chronic pancreatitis in patients 1, 3 and benign pancreatic tissue. Patient 1 had repeat EUS guided FNA which again showed chronic pancreatitis then ultimately underwent a Whipple procedure due to interval increase in size of FDG avid uptake involving the pancreatic head/uncinate process measuring approximately 2.2 cm in maximum from 1.4 cm; however, postoperative pathology revealed only chronic inflammation. The remaining two patients were observed with resolution of pancreatitis on subsequent radiologic studies. None of the patients exhibited classic symptoms of pancreatitis, such as abdominal pain or malabsorption.Conclusions This case series underscores the diagnostic complexity of ICI-P, particularly when it radiographically resembles pancreatic cancer. Comprehensive diagnostic evaluations - including imaging and tissue sampling - are essential to avoid unnecessary surgical interventions. As the use of ICIs grows, increased awareness of rare and atypical irAEs like ICI-P is critical for optimal patient care.Abstract 1075 Table 1Summary of imaging and diagnostic findings",
  "authors": [
    {
      "affiliations": [
        "Seoul National University College of Medicine, Seoul, Republic of Korea"
      ],
      "name": "Soyun Lim"
    },
    {
      "affiliations": [
        "Inova Schar Cancer Institute, Fairfax, VA, USA"
      ],
      "name": "Jafar Al-Mondhiry"
    },
    {
      "affiliations": [
        "Inova Schar Cancer Institute, Fairfax, VA, USA"
      ],
      "name": "Sekwon Jang"
    }
  ],
  "title": "1075 Case series of pancreatitis from immune checkpoint inhibitors mimicking pancreatic malignancy",
  "uid": "1d95f4bc-a648-59e9-a829-89ab36056f27"
}