Background : Isolated pancreatic Tuberculosis (TB) is a rare extrapulmonary TB, even in endemic regions such as Indonesia, especially in an immunocompetent patient. Pancreatic head TB may present as an obstructive jaundice case with a pancreatic head mass suspected of malignancy.

Methods : We report a curious case of pancreatic head TB in a 19-year-old male patient.

Results : A 19-year-old male patient was referred to us with obstructive jaundice due to a pancreatic head mass that was suspected to be malignant. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP) by internal medicine for biopsy and stent placement. The biopsy results showed atypical cells. The team proceeded with classic Whipple’s procedure because malignancy cannot be ruled out. The final pathology result of the mass showed TB of the pancreatic head tissue. The patient did not have a history of TB before, and a complete TB workup by the pulmonary team did not suggest TB in any other organ. He was immediately started on anti-tuberculosis medicine after surgery with a good response.

Conclusions : Isolated pancreatic head TB is rare and can be misdiagnosed as malignancy. A multidisciplinary approach is essential in diagnosing and managing such a curious case. In addition, as we are a high-volume center, the indications of Whipple’s procedure have been extended to cases with unclear biopsy results or even benign diseases with good results.