Tarikere Indushekar, Shenoy Madhava, Anand Rishit, Sreeram Saraswathy, Mohammed Ashfaque
Department of Surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Department of Surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Int J Surg Case Rep. 2025 Sep;134:111709. doi: 10.1016/j.ijscr.2025.111709. Epub 2025 Jul 23.
Pancreatic lipomas are rare benign mesenchymal tumors, usually asymptomatic and incidentally detected on radiological investigations due to their unique characteristic appearance on imaging. However, a rare case presented with symptoms, and required surgical management, which is reported here.
A 59-year-old woman with abdominal pain, reduced appetite, and non-bilious vomiting was found to have a pancreatic head lipoma compressing adjacent organs. She underwent Pancreaticoduodenectomy, as she was symptomatic due to obstruction, and the radiological imaging confirmed the presence of CBD stricture and pancreatic head lipoma compressing the D2. The postoperative course was uneventful without any complications, and the patient was discharged on POD 9.
Pancreatic lipomas are most commonly found in the head of the pancreas; they are usually asymptomatic (Butler et al., 2016); if symptomatic - it is often due to the compressive effect of the lesion on neighboring structures. As in our case, the lesion was compressing over D2, producing obstructive symptoms. The current low morbidity and mortality rates associated with pancreatic resection justify the operative approach, even after knowing the benign nature of the lesion.
This case emphasizes the importance of recognizing and treating symptomatic pancreatic lipomas and the need for a careful, team-based approach in managing rare pancreatic tumors.
胰腺脂肪瘤是罕见的良性间叶组织肿瘤，通常无症状，因在影像学检查中具有独特的特征性表现而偶然被发现。然而，有一例罕见病例出现了症状，需要手术治疗，在此予以报道。
一名59岁女性，有腹痛、食欲减退和非胆汁性呕吐症状，经检查发现胰头脂肪瘤压迫相邻器官。由于梗阻导致症状出现，且影像学检查证实存在胆总管狭窄和胰头脂肪瘤压迫十二指肠降部（D2），她接受了胰十二指肠切除术。术后过程顺利，无任何并发症，患者于术后第9天出院。
胰腺脂肪瘤最常见于胰头；通常无症状（巴特勒等人，2016年）；如果出现症状，往往是由于病变对邻近结构的压迫作用。如我们的病例，病变压迫十二指肠降部，产生梗阻症状。即使在知道病变为良性的情况下，目前与胰腺切除术相关的低发病率和死亡率也证明了手术方法的合理性。
本病例强调了识别和治疗有症状的胰腺脂肪瘤的重要性，以及在处理罕见胰腺肿瘤时采用谨慎的、基于团队的方法的必要性。
