Pancreatic lipoma: a pancreatic incidentaloma; diagnosis with ultrasound, computed tomography and magnetic resonance imaging

Sitharama, Suhas Aithal; Bashini, M Madhu; Gunasekaran, Kannan; Subramania, Deepak Barathi

doi:10.1259/bjrcr.20150507

Cited by 7 publications

(9 citation statements)

References 15 publications

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“…Histologically, a lipoma is an encapsulated mass of mature adipose cells arranged in lobules, and may contain fine connective tissue septa. A thin capsule differentiates a lipoma from lipomatosis and facilitates its enucleation; lipomatosis defined as replacement of pancreatic fatty tissue by fat [2] .Therefore, lipomas may not be as rare as previously thought as they may be missed or not reported [3] . Moreover, small lesions may be difficult to recognize on thick slices due to volume averaging effects.…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic Lipoma: A Pancreatic Incidentaloma Diagnosis with Computed Tomography

Beddi

Merzem

Harmak

et al. 2021

European Journal of Case Reports in Internal Medicine

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Lipoma of the pancreas is a rare benign tumour which is usually discovered incidentally on imaging. We present a case of an incidentally discovered pancreatic lipoma in a 79-year-old man with non-metastatic prostate adenocarcinoma who was referred to radiology for follow-up imaging. Fat-containing tumours originating from the pancreas are very rare. Most lipomas show characteristic features on imaging that allow their differentiation. We present the imaging features of a pancreatic lipoma on ultrasound, CT and MRI, discuss the differential diagnosis, and provide a brief review of the literature.

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Section: Discussionmentioning

confidence: 99%

“…Symptomatic intrapancreatic lipoma may require surgical treatment. Ultrasound is not the best method for detecting pancreatic lipomas [3] . These tumours are characteristically well-defined, homogeneous and usually hyperechoic.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Lipoma: A Pancreatic Incidentaloma Diagnosis with Computed Tomography

Beddi

Merzem

Harmak

et al. 2021

European Journal of Case Reports in Internal Medicine

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“…Mesenchymal tumors of the pancreas belong to rare tumors and account for 1–2% of all pancreatic tumors. Among these, lipoma and liposarcoma, fat-originating lesions, are the rarest and may be incidentally detected [ 138 , 139 ]. To emphasize the fact that these lesions may be PIs despite low incidence and enhancement of knowledge, we focus on them in this part of the review.…”

Section: Types Of Incidental Pancreatic Lesionsmentioning

confidence: 99%

“…For this reason, CT is recommended and demonstrates lipoma as a homogeneously hypodense, non-enhancing mass with density values ranging from 30 to 120 Hounsfield units with distinct margins and no infiltration of surrounding tissues. In turn, MR presents lipoma as hyperintensive lesion on both T1 and T2-weighted sequences, similar to intra-abdominal and subcutaneous fat [ 138 , 139 , 140 ]. Histological diagnostics are used in only a few cases, usually after surgical intervention [ 142 ].…”

Section: Types Of Incidental Pancreatic Lesionsmentioning

confidence: 99%

“…A thin capsule differentiates lipoma from lipomatosis, that is, focal fat replacement as deposition of the fatty tissue in the pancreatic parenchyma in continuity with the peripancreatic fat [ 139 , 140 ]. The majority of lipomas are located in the head of pancreas and are less than 5 cm in size, however giant tumors have also been reported [ 138 , 139 , 141 ]. In the diagnosis of lipoma, ultrasound is not the reference method, because this tumor may be hypo-, iso- or hyperechoic lesion.…”

Section: Types Of Incidental Pancreatic Lesionsmentioning

confidence: 99%

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Pancreatic Incidentaloma

Caban

Małecka-Wojciesko

2022

JCM

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Pancreatic incidentalomas (PIs) represent a clinical entity increasingly recognized due to advances in and easier access to imaging techniques. By definition, PIs should be detected during abdominal imaging performed for indications other than a pancreatic disease. They range from small cysts to invasive cancer. The incidental diagnosis of pancreatic cancer can contribute to early diagnosis and treatment. On the other hand, inadequate management of PIs may result in overtreatment and unneeded morbidity. Therefore, there is a strong need to evaluate the nature and clinical features of individual PIs. In this review, we summarize the major characteristics related to PIs and present suggestions for their management.

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Pancreatic ductal adenocarcinoma arising from the pancreatic parenchyma compressed by a huge pancreatic lipoma: a case report

et al. 2023

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Background Pancreatic lipomas (PLs) arising from the adipose tissue in the pancreatic parenchyma are rare among pancreatic tumors. Coexisting pancreatic ductal adenocarcinoma (PDAC) and PLs have not been previously reported. Herein, we report a case of PDAC arising from the pancreatic parenchyma with chronic pancreatitis compressed by a large PL. Case presentation The patient was a 69-year-old male. He had been diagnosed with a PL using computed tomography (CT) 12 years previously. The tumor had been slowly growing and was followed up carefully because of the possibility of well-differentiated liposarcoma. During follow-up, laboratory data revealed liver damage and slightly elevated levels of inflammatory markers. Contrast-enhanced CT revealed the previously diagnosed 12 cm pancreatic head tumor and an irregular isodensity mass at the upper margin of the tumor that invaded and obstructed the distal common bile duct. Magnetic resonance cholangiopancreatography demonstrated no specific findings in the main pancreatic duct. Based on these imaging findings, the patient underwent endoscopic retrograde biliary drainage and bile duct brushing cytology, which revealed indeterminate findings. The differential diagnosis of the tumor at that time was as follows: (1) pancreatic liposarcoma (focal change from well-differentiated to dedifferentiated, not lipoma), (2) distal cholangiocarcinoma, and (3) pancreatic cancer. After the cholangitis improved, a pancreatoduodenectomy was performed. Histologically, hematoxylin–eosin staining revealed moderately differentiated PDAC compressed by proliferating adipose tissue. The adipose lesion showed homogeneous adipose tissue with no evidence of sarcoma, which led to a diagnosis of lipoma. Additionally, extensive fibrosis of the pancreatic parenchyma and atrophy of the acinar cells around the lipoma was suggestive of chronic pancreatitis. The pathological diagnosis was PDAC (pT2N0M0 pStage Ib) with chronic pancreatitis and PL. The postoperative course was uneventful, and the patient was discharged on the 15th day after surgery. The patient received adjuvant chemotherapy and has remained recurrence-free for more than 6 months. Conclusions PL may be associated with the development of PDAC in the surrounding inflammatory microenvironment of chronic pancreatitis. In cases of growing lipomas, careful radiologic surveillance may be needed not only for the possibility of liposarcoma but also for the coincidental occurrence of PDAC.

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Pancreatic lipoma: a pancreatic incidentaloma; diagnosis with ultrasound, computed tomography and magnetic resonance imaging

Cited by 7 publications

References 15 publications

Pancreatic Lipoma: A Pancreatic Incidentaloma Diagnosis with Computed Tomography

Pancreatic Lipoma: A Pancreatic Incidentaloma Diagnosis with Computed Tomography

Pancreatic Incidentaloma

Pancreatic ductal adenocarcinoma arising from the pancreatic parenchyma compressed by a huge pancreatic lipoma: a case report

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