Limits...
Pancreatic panniculitis associated with pancreatic carcinoma: A case report.

Zhang G, Cao Z, Yang G, Wu W, Zhang T, Zhao Y - Medicine (Baltimore) (2016)

Bottom Line: A physical examination revealed subcutaneous nodules on his lower extremities.The blood test showed abnormal increases in amylase, lipase, and carbohydrate antigen 19-9 levels.A computed tomography scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

ABSTRACT

Introduction: Pancreatic panniculitis is a very rare complication of pancreatic cancer, most often accompanying rare acinar cell carcinoma. We herein report a case of pancreatic panniculitis that was associated with pancreatic mucinous adenocarcinoma.

Patient information: A 57-year-old male was referred to our hospital for weight loss. A physical examination revealed subcutaneous nodules on his lower extremities. The blood test showed abnormal increases in amylase, lipase, and carbohydrate antigen 19-9 levels. A computed tomography scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas. The biopsy of subcutaneous nodules on the lower extremities was conducted and revealed lobular panniculitis. Pancreatic cancer and pancreatic panniculitis were strongly suspected. After the administration of octreotide acetate and the Whipple procedure, the serous amylase and lipase levels returned to normal, and the pancreatic panniculitis had almost resolved by 4 weeks later.

Conclusion: Pancreatic panniculitis is a rare complication of pancreatic cancer. However, in the presence of a pancreatic mass, as in this case, clinicians should be aware that panniculitis may be the sentinel of pancreatic carcinoma.

No MeSH data available.


Related in: MedlinePlus

Imaging findings from the pancreatic tumor. (A) Computed tomography detected a 2 × 1.5 cm hypodense solid mass with an unclear margin in the head of the pancreas; (B) expanded primary pancreatic duct and the cystic low density in the tail of pancreas; (C) cystic low density in the uncinate process of the pancreas; (D) PET-CT revealed a malignant mass in the pancreatic head.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4979799&req=5

Figure 2: Imaging findings from the pancreatic tumor. (A) Computed tomography detected a 2 × 1.5 cm hypodense solid mass with an unclear margin in the head of the pancreas; (B) expanded primary pancreatic duct and the cystic low density in the tail of pancreas; (C) cystic low density in the uncinate process of the pancreas; (D) PET-CT revealed a malignant mass in the pancreatic head.

Mentions: A computed tomography (CT) scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas with homogenous lower enhancement compared to the surrounding pancreatic parenchyma by intravenous contrast in the arterial phase (Fig. 2A). In addition, we observed an expanded primary pancreatic duct and inter- and extra-bile ducts in addition to cholecyst and multiple cystic lesions in the swollen pancreas with rough edges (Fig. 2B and C). Positron emission tomography-computed tomography revealed a malignant mass in the pancreatic head (Fig. 2D). We conducted a biopsy of the subcutaneous nodules on the lower extremities. The pathology results indicated lobular panniculitis with foci of necrosis and “ghost” cells characterized by anucleated adipocytes with partially digested shadowy cell membranes (Fig. 1B). Pancreatic cancer and PP were strongly suspected.


Pancreatic panniculitis associated with pancreatic carcinoma: A case report.

Zhang G, Cao Z, Yang G, Wu W, Zhang T, Zhao Y - Medicine (Baltimore) (2016)

Imaging findings from the pancreatic tumor. (A) Computed tomography detected a 2 × 1.5 cm hypodense solid mass with an unclear margin in the head of the pancreas; (B) expanded primary pancreatic duct and the cystic low density in the tail of pancreas; (C) cystic low density in the uncinate process of the pancreas; (D) PET-CT revealed a malignant mass in the pancreatic head.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979799&req=5

Figure 2: Imaging findings from the pancreatic tumor. (A) Computed tomography detected a 2 × 1.5 cm hypodense solid mass with an unclear margin in the head of the pancreas; (B) expanded primary pancreatic duct and the cystic low density in the tail of pancreas; (C) cystic low density in the uncinate process of the pancreas; (D) PET-CT revealed a malignant mass in the pancreatic head.
Mentions: A computed tomography (CT) scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas with homogenous lower enhancement compared to the surrounding pancreatic parenchyma by intravenous contrast in the arterial phase (Fig. 2A). In addition, we observed an expanded primary pancreatic duct and inter- and extra-bile ducts in addition to cholecyst and multiple cystic lesions in the swollen pancreas with rough edges (Fig. 2B and C). Positron emission tomography-computed tomography revealed a malignant mass in the pancreatic head (Fig. 2D). We conducted a biopsy of the subcutaneous nodules on the lower extremities. The pathology results indicated lobular panniculitis with foci of necrosis and “ghost” cells characterized by anucleated adipocytes with partially digested shadowy cell membranes (Fig. 1B). Pancreatic cancer and PP were strongly suspected.

Bottom Line: A physical examination revealed subcutaneous nodules on his lower extremities.The blood test showed abnormal increases in amylase, lipase, and carbohydrate antigen 19-9 levels.A computed tomography scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

ABSTRACT

Introduction: Pancreatic panniculitis is a very rare complication of pancreatic cancer, most often accompanying rare acinar cell carcinoma. We herein report a case of pancreatic panniculitis that was associated with pancreatic mucinous adenocarcinoma.

Patient information: A 57-year-old male was referred to our hospital for weight loss. A physical examination revealed subcutaneous nodules on his lower extremities. The blood test showed abnormal increases in amylase, lipase, and carbohydrate antigen 19-9 levels. A computed tomography scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas. The biopsy of subcutaneous nodules on the lower extremities was conducted and revealed lobular panniculitis. Pancreatic cancer and pancreatic panniculitis were strongly suspected. After the administration of octreotide acetate and the Whipple procedure, the serous amylase and lipase levels returned to normal, and the pancreatic panniculitis had almost resolved by 4 weeks later.

Conclusion: Pancreatic panniculitis is a rare complication of pancreatic cancer. However, in the presence of a pancreatic mass, as in this case, clinicians should be aware that panniculitis may be the sentinel of pancreatic carcinoma.

No MeSH data available.


Related in: MedlinePlus