A Case of Lipomatous Pseudohypertrophy of the Pancreas

Lipomatous Pseudohypertrophy of the Pancreas Taking the Form of Huge Massive Lesion of the Pancreatic Head

“…A literature search of Japana Centra Revuo Medicina and PubMed revealed only 27 other cases worldwide, including those in which the condition was diagnosed with imaging alone [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Unlike steatosis resulting from obstruction of the pancreatic duct by pancreatolithiasis or a tumor, the causal factors of this disease are unknown.…”

“…LiPH of the pancreas is an extremely rare disease that is defined by (1) the enlargement and increased weight of the pancreas and morphological uniformity of the pancreas, (2) complete replacement of the pancreatic exocrine tissue by fatty tissue, and (3) sparing of the pancreatic duct system and islets of Langerhans [ 1 ]. A literature search of Japana Centra Revuo Medicina and PubMed revealed only 27 other cases worldwide, including those in which the condition was diagnosed with imaging alone [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Unlike steatosis resulting from obstruction of the pancreatic duct by pancreatolithiasis or a tumor, the causal factors of this disease are unknown.…”

“…Unlike steatosis resulting from obstruction of the pancreatic duct by pancreatolithiasis or a tumor, the causal factors of this disease are unknown. Postulated causative mechanisms include congenital anomaly, pancreatic exocrine gland obstruction, and viral infection [ 2 , 13 ].…”

“…Besides the present case, there were only 4 cases in which LiPH developed in the pancreatic head [ 15 , 16 ], hence this distribution appears to be extremely rare. The weight of the pancreas varied from 130 g to more than 1,200 g; it was at least twice that of the normal pancreas, and in most cases 3 times or more [ 6 , 13 ]. Methods of diagnosis were autopsy (11 cases), surgery after diagnosis of liposarcoma or carcinoma (12 cases), and diagnostic imaging alone (5 cases).…”

“…Methods of diagnosis were autopsy (11 cases), surgery after diagnosis of liposarcoma or carcinoma (12 cases), and diagnostic imaging alone (5 cases). Symptoms did not determine diagnosis, and although many cases were accompanied by abnormal glucose tolerance or fatty liver, these abnormalities were not necessarily present [ 13 ]. Coexisting diseases included cirrhosis of the liver (including that due to hepatitis B) and primary sclerosing cholangitis [ 9 , 10 , 15 ], and it seems possible that chronic liver injury influences the development of LiPH of the pancreas.…”