Idiopathic fibrosing pancreatitis and spontaneous resolution of pancreatic masses in children.

A symptomatic pancreatic mass poses both a diagnostic and therapeutic conundrum. First, benign conditions may mimic malignancy and second, the management of benign lesions has not been well defined. We reviewed four such cases and discuss the management of juvenile idiopathic fibrosing pancreatitis in the light of these. In four children with symptomatic pancreatic masses/enlargement (three with jaundice) all resolved spontaneously without definitive intervention. Histopathology, obtained in two cases, revealed a fibrotic chronic inflammatory reaction. Pancreatic masses in children may not be malignant. Resolution of symptoms including obstructive jaundice and a mass secondary to juvenile idiopathic fibrosing pancreatitis may occur spontaneously, avoiding the need for resection or definitive drainage procedures.