A 71-year-old man was referred to our hospital for the investigation of a pancreatic tumor that had been incidentally detected without symptoms on an abdominal ultrasound at a health checkup. Enhanced computed tomography revealed a hypodense mass (22 mm in size) in the pancreatic head (Picture 1, *). The coronal section of T2-weighted magnetic resonance imaging shows the main pancreatic duct (MPD, arrow) penetrating the mass, depicted with a slightly high-intensity signal (Picture 2, arrowheads). Endoscopic ultrasound (EUS) confirmed that the MPD (arrow) had penetrated the low-echoic mass (arrowheads) without narrowing or shifting (Picture 3). The sample obtained by an EUS-guided fine-needle biopsy contained thick, whitish tissues with oil droplets. A pathological examination revealed adipose tissue (arrows) with islands of non-neoplastic pancreatic acini (arrowheads) (Picture 4), leading to the diagnosis of pancreatic lipoma. A pancreatic lipoma is a rare mesenchymal tumor incidentally detected on imaging examinations, mostly showing typical findings (1,2). Although duct-penetrating signs have only rarely been reported, they may explain the softness of this tumor.
Picture 1.
Picture 2.
Picture 3.
Picture 4.
The authors state that they have no Conflict of Interest (COI).
References
- 1.Zhan HX, Zhang TP, Liu BN, Liao Q, Zhao YP. A systematic review of pancreatic lipoma: how come there are so few cases? Pancreas 39: 257-260, 2010. [DOI] [PubMed] [Google Scholar]
- 2.Stadnik A, Cieszanowski A, Bakoń L, Grodzicka A, Rowiński O. Pancreatic lipoma: an incydentaloma which can resemble cancer - analysis of 13 cases studied with CT and MRI. Pol J Radiol 77: 9-13, 2012. [DOI] [PMC free article] [PubMed] [Google Scholar]