Symptomatic Pancreatic Lipoma

Excerpt

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.

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