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Erschienen in:
22.01.2019 | GI Image
Symptomatic Pancreatic Lipoma
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 9/2019
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An otherwise healthy 41-year-old female was referred to surgical oncology clinic after approximately 1 year of progressive epigastric pain, early satiety, and diarrhea. There was no history of weight loss, jaundice, or pancreatitis. A computed tomography (CT) scan demonstrated a 4.7 cm × 4.2 cm mass (averaging − 95 Hounsfield units (HU), consistent with the density of fat tissue) in the head of the pancreas, suggestive of a lipoma (Fig. 1). There was mild heterogeneity but no enhancing or myxoid components to suggest a high-grade liposarcoma. Serum CA 19-9 level was normal. Given the duration of symptoms and the size of the lesion, pancreaticoduodenectomy was recommended. At exploration, a soft fullness was palpable in the head of the pancreas. There was no vascular invasion or pathologic lymphadenopathy. The operation proceeded uneventfully. Final pathology revealed a well-circumscribed, 4.8-cm unencapsulated fatty lesion infiltrating the head of the pancreas. The mass was benign, consisting of mature adipose tissue (Fig. 2), with negative margins and 24 benign lymph nodes. On follow-up examination, postoperative recovery was unremarkable and all prior symptoms had resolved.
Fig. 1
Coronal (a) and axial (b) images demonstrating a pancreatic mass (arrows) with enhancement similar to subcutaneous fat, without invasion into surrounding structure, and with mild heterogeneity in the mass
Fig. 2
Pancreas tissue and entirely bland, unencapsulated adipose tissue consisting of mature adipocytes consistent with intrapancreatic lipoma. There is no lipoblastic differentiation or nuclear atypia to suggest liposarcoma. The background pancreas shows no abnormality
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