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Jairo M, Germán T, Isabel B, Gloria M, Rúben Á. Symptomatic pancreatic lipoma managed with a metallic biliary stent: Case report. Int J Surg Case Rep 2022; 93:106972. [PMID: 35364388 PMCID: PMC8971632 DOI: 10.1016/j.ijscr.2022.106972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Presentation of case Discussion Conclusion Mesenchymal tumors comprise 1 to 2% of all pancreatic tumors and lipomas are a rare variant of mesenchymal tumors of the pancreas. The vast majority >95% of PL are asymptomatic; however, some of them can produce pancreatic or biliary obstruction, or both. To the best of our knowledge this is the first reported case of symptomatic PL in Colombia and the second in Latin America
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Deschner B, Gandhi J, Deneve JL, Dickson PV, Clark I, Glazer ES. Symptomatic Pancreatic Lipoma. J Gastrointest Surg 2019; 23:1942-1943. [PMID: 30671802 DOI: 10.1007/s11605-019-04105-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 01/01/2019] [Indexed: 01/31/2023]
Affiliation(s)
- Benjamin Deschner
- Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave., Suite 300, Memphis, TN, 38163, USA
| | - Jatin Gandhi
- Department of Pathology, University of Tennessee Health Science Center, 930 Madison Ave., Memphis, TN, 38163, USA
| | - Jeremiah L Deneve
- Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave., Suite 300, Memphis, TN, 38163, USA
| | - Paxton V Dickson
- Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave., Suite 300, Memphis, TN, 38163, USA
| | - Ian Clark
- Department of Pathology, University of Tennessee Health Science Center, 930 Madison Ave., Memphis, TN, 38163, USA
| | - Evan S Glazer
- Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave., Suite 300, Memphis, TN, 38163, USA.
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Aithal Sitharama S, Bashini M, Gunasekaran K, Barathi Subramania D. Pancreatic lipoma: a pancreatic incidentaloma; diagnosis with ultrasound, computed tomography and magnetic resonance imaging. BJR Case Rep 2016; 2:20150507. [PMID: 30460031 PMCID: PMC6243312 DOI: 10.1259/bjrcr.20150507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/24/2016] [Accepted: 05/18/2016] [Indexed: 12/14/2022] Open
Abstract
Pancreatic lipomas are rare. We present a case of incidentally discovered pancreatic lipoma in a 45-year-old female suffering from metastatic ovarian carcinoma who was referred to radiology for follow-up imaging. Fat-containing tumours originating from the pancreas are very rare. Most lipomasshow characteristic features on imaging that allow their differentiation. In most cases, accurate diagnosis is attained without any histopathological confirmation. We present the imaging features of pancreatic lipoma on ultrasound, CT scan and MRI, the differential diagnosis and a brief review of the literature.
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Affiliation(s)
- Suhas Aithal Sitharama
- Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Manju Bashini
- Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Kannan Gunasekaran
- Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Deepak Barathi Subramania
- Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Butler JR, Fohtung TM, Sandrasegaran K, Ceppa EP, House MG, Nakeeb A, Schmidt CM, Zyromski NJ. The natural history of pancreatic lipoma: Does it need observation. Pancreatology 2015; 16:95-8. [PMID: 26682506 DOI: 10.1016/j.pan.2015.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/06/2015] [Accepted: 11/17/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pancreatic lipomas (PL) are a rare, benign mesenchymal neoplasm. Some patients diagnosed with PL are followed radiographically or referred to a second provider, while others are not followed after incidental diagnosis. In this study we describe 74 cases of intrapancreatic lipomas from a single institution over a 12-year period to elucidate the radiologic and clinical natural history of pancreatic lipoma. METHODS In the period from January 2001 to December 2013, we selected patients over the age of 18 diagnosed with PL based on Ultrasound, CT, and MR imaging. Clinical data were coupled with review of the radiographic image. These patients were retrospectively followed to establish the significance of PL. RESULTS PL was identified in 0.012% of all patients undergoing cross-sectional imaging during the studied interval. Lipomas ranged in size at diagnosis from 0.1 cm to 4.8 cm. The majority of patients were asymptomatic at presentation. No patient required intervention or exhibited a change in lipoma diagnosis over a median follow up interval of 41.5 months (range 2-145). 47 patients underwent subsequent imaging with a median of two additional exams (range 2-113) over 31 months (range 1-18). 46/47 (98%) patients with subsequent images showed no discernible growth; 1/47 (2%) had a resolution of the lipoma. CONCLUSIONS Pancreatic lipomas are rare benign mesenchymal neoplasms that exhibit stable size and morphology. They are overwhelmingly asymptomatic. The natural history of pancreatic lipoma is benign. Short-term interval observation is prudent to prove stability and help differentiate from early liposarcoma. Extensive follow-up is not likely necessary for this benign lesion.
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Affiliation(s)
- James R Butler
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tanyi M Fohtung
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kumar Sandrasegaran
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eugene P Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael G House
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Attila Nakeeb
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - C Max Schmidt
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nicholas J Zyromski
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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Large pancreatic lipoma in a 69-year-old diabetic woman: diagnostic considerations. GASTROENTEROLOGY REVIEW 2014; 9:168-71. [PMID: 25097715 PMCID: PMC4110364 DOI: 10.5114/pg.2014.43579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 09/08/2012] [Accepted: 11/18/2012] [Indexed: 02/07/2023]
Abstract
Pancreatic mesenchymal neoplasms are very rare pancreatic tumours. One of them is pancreatic lipoma, often diagnosed incidentally. We herein report a case of a large lipoma of the pancreatic head, diagnosed by computed tomography and magnetic resonance imaging and confirmed by ultrasound-guided fine needle biopsy (FNA) biopsy. Regarding its benign character, silent clinical course and excellent prognosis of invasive surgical removal was avoided. We propose here the diagnostic and therapeutic management of these rare pancreatic tumours. Computed tomography is the most accurate method to diagnose pancreatic lipoma. Nevertheless large tumours may need confirmation by FNA in differential diagnosis of liposarcoma.
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Prathvi S, Jnaneshwari J. Sneaky pancreatic head mass. Oman Med J 2012; 27:70-1. [PMID: 22359732 PMCID: PMC3282132 DOI: 10.5001/omj.2012.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 11/24/2011] [Indexed: 11/03/2022] Open
Affiliation(s)
- Shetty Prathvi
- Department of Surgery Father Muller Medical Collage and Hospital. Kankanady Mangalore 575002 Karnataka.India
| | - Tauro Leo F
- Department of Surgery Father Muller Medical Collage and Hospital. Kankanady Mangalore 575002 Karnataka.India
| | - Jayaram Jnaneshwari
- Department of Surgery Father Muller Medical Collage and Hospital. Kankanady Mangalore 575002 Karnataka.India
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Lee JY, Seo HI, Park EY, Kim GH, Park DY, Kim S. Histologic confirmation of huge pancreatic lipoma: a case report and review of literatures. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2011; 81:427-30. [PMID: 22200046 PMCID: PMC3243862 DOI: 10.4174/jkss.2011.81.6.427] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 02/17/2011] [Accepted: 02/22/2011] [Indexed: 12/14/2022]
Abstract
Pancreatic lipomas are commonly diagnosed based on radiologic images, although the prevalence of lipomas has not been established. Histologic confirmation of pancreatic lipomas is extremely rare because surgical treatment is unnecessary in most cases. Endoscopic ultrasound-guided fine-needle aspiration cytology has been suggested to avoid unnecessary surgery to distinguish between a lipoma and a well-differentiated liposarcoma; however, surgery would be needed when the tumor is associated with symptoms or difficult to distinguish from a liposarcoma. We present a case of a pancreatic lipoma in a 54-year-old male patient that was histologically-confirmed by subtotal pancreatectomy.
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Affiliation(s)
- Jee Yeon Lee
- Department of Surgery, Pusan National University School of Medicine, Yangsan, Korea
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Lee SY, Thng CH, Chow PKH. Lipoma of the pancreas, a case report and a review of the literature. World J Radiol 2011; 3:246-8. [PMID: 22229078 PMCID: PMC3252557 DOI: 10.4329/wjr.v3.i10.246] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 07/25/2011] [Accepted: 08/01/2011] [Indexed: 02/06/2023] Open
Abstract
Lipomas of the pancreas are very rare. There are fewer than 25 reported cases of lipoma originating from the pancreas. We present a case of pancreatic lipoma in a 61-year-old woman with magnetic resonance imaging findings and confirmatory histological findings. We discuss and highlight the radiological features distinguishing a pancreatic lipoma from other fatty lesions of the pancreas and pancreatic liposarcoma and provide a brief review of the literature.
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Temizoz O, Genchellac H, Unlu E, Kantarci F, Umit H, Demir MK. Incidental pancreatic lipomas: computed tomography imaging findings with emphasis on diagnostic challenges. Can Assoc Radiol J 2010; 61:156-61. [PMID: 20350800 DOI: 10.1016/j.carj.2010.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Revised: 01/08/2010] [Accepted: 01/12/2010] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The purpose of this study was to describe the computed tomography (CT) findings of pancreatic lipomas of 9 cases, with emphasis to diagnostic challenges. METHODS Between March 2006 and April 2008, 9 patients with pancreatic lipomas that were diagnosed by CT were reviewed in the present study. Clinical data and CT features of these 9 cases were retrospectively analysed. The patient population included 5 men and 4 women, aged 42-81 years (mean age, 65.8 years). The patients were followed up for at least 2 years with control CTs. RESULTS In all 9 cases, a well-bordered nodular fat density lesion was incidentally detected in the pancreas. Four of the lesions had a lobulated contour, and 2 of them had septations. Two of the lipomas were located in the head, 3 in the neck, 3 in the corpus, and 1 in the tail. The CT densitometric values were between -90 and -120 HU, with a mean value of -106 HU. No pancreatic or biliary dilatation or compression to the adjacent structures was seen. All the cases had control CTs, and the lipomas remained unchanged during the follow-up period. Histopathologic confirmation of the diagnosis was not planned for the cases. CONCLUSION Lipomas are rarely encountered in the pancreas. They often are diagnosed coincidentally as small, well-circumscribed, encapsulated, homogeneous, mature adipose masses on imaging studies. Imaging follow-up strategy or histopathologic confirmation is not necessary in asymptomatic patients.
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Affiliation(s)
- Osman Temizoz
- Department of Radiology, Trakya University Faculty of Medicine, Edirne, Turkey.
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Di Matteo FM, Shimpi L, Pandolfi M, Rabitti C, Fabio C, Gabbrielli A, Costamagna G. EUS diagnosis of pancreatic lipoma: a case report. Gastrointest Endosc 2006; 64:146-8. [PMID: 16813829 DOI: 10.1016/j.gie.2006.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Accepted: 02/06/2006] [Indexed: 12/10/2022]
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Hois EL, Hibbeln JF, Sclamberg JS. CT appearance of incidental pancreatic lipomas: a case series. ACTA ACUST UNITED AC 2006; 31:332-8. [PMID: 16705398 DOI: 10.1007/s00261-005-0362-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pancreatic lipomas are rare benign lesions, with only 15 examples documented in the current literature. We describe five cases of intrapancreatic lipomas from a single institution, all incidentally found using computed tomography within a 14-month period. Computed tomography depicted lipomas as homogeneous, nonenhancing, well-marginated lesions with a density coefficient consistent with adipose tissue.
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Affiliation(s)
- E L Hois
- Department of Radiology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612-3833, USA
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Adsay NV, Basturk O, Klimstra DS, Klöppel G. Pancreatic pseudotumors: non-neoplastic solid lesions of the pancreas that clinically mimic pancreas cancer. Semin Diagn Pathol 2005; 21:260-7. [PMID: 16273945 DOI: 10.1053/j.semdp.2005.07.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the pancreas, a variety of non-neoplastic conditions may form solid masses that may mimic cancer. Up to 5% of pancreatectomies performed with the preoperative clinical diagnosis of carcinoma will prove to be non-neoplastic by pathologic examination, although this figure is decreasing with improved diagnostic modalities. Chronic inflammatory lesions are the leading cause of this phenomenon ("pseudotumoral pancreatitis"), and among these, autoimmune and paraduodenal pancreatitides (discussed separately in this issue) are most important. In this article, we will focus on the noninflammatory lesions that may form tumor-like lesions of the pancreas. Adenomyomatous hyperplasia of ampulla of Vater is a subtle lesion that is difficult to define; larger examples (>5 mm) have been found to be the cause of obstructive jaundice. Accessory (heterotopic) spleen may form a well-defined nodule within the tail of the pancreas and is typically mistaken for endocrine neoplasm. Lipomatous hypertrophy is the replacement of pancreatic tissue with mature adipose tissue that occasionally leads to moderate to marked enlargement of the pancreas. Hamartomas are very rare if the entity is defined strictly. They are characterized by irregularly arranged mature pancreatic elements admixed with stromal tissue. A cellular, spindle-cell variant with c-kit (CD117) expression is recognized. Pseudolymphoma forms well-defined nodules composed of hyperplastic lymphoid tissue. Rarely, foreign-body deposits, granulomatous inflammations (such as sarcoidosis or tuberculosis), and congenital lesions may form tumoral lesions. In conclusion, it is important to recognize the types of conditions that form pseudotumors in the pancreas so that they can be distinguished from ductal adenocarcinomas, especially clinically, but also pathologically. Nonspecific terms such as "inflammatory pseudotumor" ought to be avoided, and every attempt should be made to classify a "pseudotumor" into a more specific diagnostic category discussed above.
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Affiliation(s)
- N Volkan Adsay
- Karmanos Cancer Institute/Wayne State University, Detroit, Michigan, USA.
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Rebordosa S, Dolors Esteba M, Romero I. Casos en imagen 1.—Lipoma pancreático. RADIOLOGIA 2005. [DOI: 10.1016/s0033-8338(05)72852-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sánchez-Alonso L, Meca J, Cantero G, Rodríguez-Mondéjar R. Lipoma pancreático. Presentación de un caso y revisión de la bibliografía. RADIOLOGIA 2005. [DOI: 10.1016/s0033-8338(05)72832-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Moriki T, Ohtsuki Y, Takahashi T, Ueta S, Mitani M, Ichien M, Fukata S, Murata Y. Lipoma-like tumor mass probably arising in the retroperitoneal heterotopic pancreas: A previously undescribed lesion. Pathol Int 2004; 54:527-31. [PMID: 15189508 DOI: 10.1111/j.1440-1827.2004.01661.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Heterotopic pancreatic tissue is found in several locations of the body. However, to the best of our knowledge, there have been no reports on heterotopic pancreas in the retroperitoneum. A case of retroperitoneal lipoma-like large tumor mass probably arising in the heterotopic pancreas is reported. A 45-year-old Japanese woman was admitted to hospital because of back pain. Imaging modalities showed an abnormal mass in the retroperitoneum separate from the surrounding organs, including the pancreas and kidney. Histologically, the mass consisted of mature adipose tissue and scattered ductal and acinar elements. Although there was no islet tissue in this fatty mass, the epithelial elements suggested heterotopic pancreatic tissue in origin. The present case is very unusual; however, heterotopic pancreas should be considered in the differential diagnosis of retroperitoneal tumors.
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Affiliation(s)
- Toshiaki Moriki
- Department of Clinical Laboratory, Kochi Medical School Hospital, Kochi, Japan.
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