Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2019; 7(16): 2352-2359
Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2352
A huge pancreatic lipoma mimicking a well-differentiated liposarcoma: A case report and systematic literature review
Ren-Yi Xiao, Xing Yao, Wei-Lin Wang
Ren-Yi Xiao, Wei-Lin Wang, Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Xing Yao, Department of General Surgery, Huzhou Central Hospital, Huzhou 313000, Zhejiang Province, China
Author contributions: Xiao RY collected case data, prepared the photos and wrote the manuscript; Yao X and Wang WL proofread and revised the manuscript; all of the authors approved the final version to be published.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.
CARE Checklist (2016) statement: The guidelines of the CARE Checklist (2016) have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wei-Lin Wang, PhD, Doctor, Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. wam@zju.edu.cn
Telephone: +86-571-87951111
Received: April 22, 2019
Peer-review started: April 23, 2019
First decision: June 12, 2019
Revised: June 18, 2019
Accepted: June 26, 2019
Article in press: June 27, 2019
Published online: August 26, 2019
Processing time: 128 Days and 13.3 Hours
Abstract
BACKGROUND

Pancreatic lipomas are thought to be very rare. Lipomas are usually easy to identify on imaging, particularly via computed tomography (CT). But sometimes it’s quite difficult to distinguish a lipoma from a well-liposarcoma without histologic result.

CASE SUMMARY

Here, we present a case of pancreatic lipoma in a 59-year-old female. She was asymptomatic and had no medical history of note. CT and magnetic resonance imaging revealed a mass like well-differentiated liposarcoma in the pancreatic head, positron emission tomography/CT showed a low fluorodeoxyglucose uptake and laboratory tests revealed elevated transaminase and carbohydrate antigen-199 levels. Finally, the patient underwent a pancreaticoduodenectomy. Histologically, mature adipocytes were noted in the bulk of the tumor. Accordingly, the pathologic diagnosis of the pancreatic neoplasm was lipoma. To our knowledge, this case is the first example of a suspected well-differentiated liposarcoma that was actually a pancreatic lipoma. We also highlight the radiological features distinguishing a pancreatic lipoma from a pancreatic liposarcoma and briefly review the literature.

CONCLUSION

Pancreatic lipomas show no obvious gender bias and most commonly occur in the head of the pancreas, of which the maximum diameters are often less than 5 cm, and small, asymptomatic non-compressed lipomas require follow-up only. Surgical excision should be considered when the tumor has compressed important tissues or is difficult to distinguish from a liposarcoma, the choice of surgery depends on the intraoperative presentation.

Keywords: Pancreatic Lipoma; Liposarcoma; Pancreas; Case report

Core tip: Pancreatic lipomas are rare, especially the huge ones. Lipomas are usually easily identified on imaging, particularly via computed tomography. Here we present the first example of a suspected well-differentiated liposarcoma on imaging that was actually a pancreatic lipoma. We also highlight the radiological features distinguishing a pancreatic lipoma from a liposarcoma and briefly review the literature.