Abstract
Pancreatic lipomatosis is characterized as massive lipid infiltration of the pancreatic tissue. Although its etiology is ill defined; obesity, diabetes mellitus, chronic pancreatitis, hereditary pancreatitis, and conditions that cause pancreatic ductal obstruction, for example tumors and stones, are related to its pathogenesis. Recently, with the increased use of computerized tomography and magnetic resonance imaging, it has become possible to observe the fat replacement of the pancreas. Herein, we report a 60-year-old man complaining of abdominal pain and weight loss. Preoperative work-up revealed a locally advanced (Stage III) pancreatic adenocarcinoma. Multimodal treatment was carried out and a 100% complete response was detected after neoadjuvant therapy. The patient underwent a standard pancreaticoduodenectomy, without complications. The tissue pathology revealed lipomatosis of the pancreas. He was disease-free and symptom-free at 1 year follow-up. To our knowledge, this is the first report in the literature of pancreatic head carcinoma with total fat replacement of the pancreas after neoadjuvant chemoradiotherapy.
Similar content being viewed by others
References
Kuroda N, Okada M, Toi M et al (2003) Lipomatous pseudohypertrophy of the pancreas: further evidence of advanced hepatic lesion as the pathogenesis. Pathol Int 53:98–101
Rosseel F, Brugman E, Fiey J et al (1996) Total fat replacement of the pancreas: case report and review of the literature. J Belge Radiol 79:199–200
Raeder H, Haldorsen IS, Ersland L et al (2007) Pancreatic lipomatosis is a structural marker in nondiabetic children with mutations in carboxyl-ester lipase. Diabetes 56:444–449
Yoshimura N, Hayashi S, Fukushima Y (1992) Diffuse Mallory bodies in the liver, diffuse Lewy bodies in the brain and diffuse fat replacement (lipomatous pseudohypertrophy) of the pancreas in a patient with juvenile Parkinson’s disease. Acta Pathol Jpn 42:826–831
Beresford OD, Owen TK (1957) Lipomatous pseudohypertrophy of the pancreas. J Clin Pathol 10:63–66
Siegler DI (1974) Lipomatous pseudohypertrophy of the pancreas associated with chronic pulmonary suppuration in an adult. Postgrad Med J 50:53–55
Dupont C, Sellier N, Chochillon C et al (1989) Pancreatic lipomatosis and duodenal stenosis or atresia in children. J Pediatr 115:603–605
Lozano M, Navarro S, Perez-Ayuso R et al (1988) Lipomatosis of the pancreas: an unusual cause of massive steatorrhea. Pancreas 3:590–592
Yi SY, Lee SK, Kim MH et al (1993) A case of the fat replacement of the pancreas showing specific ERCP finding. Korean J Gastroenterol 25:587–589
Baek SY, Lee SK, Kim MY et al (1992) CT findings of pancreas lipomatosis and associated diseases. J Korean Radiol Soc 28:749–753
MacMaster SA, Cummings TM (1993) Computed tomography and ultrasonography findings for an adult with Shwachman syndrome and pancreaticlipomatosis. Can Assoc Radiol J 44:301–303
Salm R (1960) Scirrhous adenocarcinoma arising from a lipomatous pseudohypertrophic pancreas. J Pathol Bacteriol 79:47–52
So CB, Cooperberg PL, Gibney RG et al (1987) Sonographic findings in pancreatic lipomatosis. Am J Roentgenol 149:67–68
Walters MN (1966) Adipose atrophy of the pancreas. J Pathol Bacteriol 92:547–557
Seifert G (1984) Lipomatous atrophy and other forms. In: Kloppel G, Hietz PU (eds) Pancreatic pathology. Churchill Livingstone, London, pp 27–31
Kim HJ, Byun JH, Park SH et al (2007) Focal fatty replacement of the pancreas: usefulness of chemical shift MRI. AJR Am J Roentgenol 188:429–432
Nakamura M, Katada N, Sakakibara A (1979) Huge lipomatous pseudohypertrophy of the pancreas. Am J Gastroenterol 72:171–174
Conflict of interest statement
No author has any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Makay, O., Kazimi, M., Aydin, U. et al. Fat replacement of the malignant pancreatic tissue after neoadjuvant therapy. Int J Clin Oncol 15, 88–92 (2010). https://doi.org/10.1007/s10147-009-0001-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-009-0001-9