Pancreatic hamartoma: a case report and literature review

Abstract

BackgroundPancreatic hamartoma is an extremely rare benign disease of the pancreas. Only 30 cases have been reported to date.Case presentationA 68-year-old man presented with an asymptomatic solid and multi-cystic lesion in the uncus of the pancreas, incidentally detected on abdominal enhanced computed tomography. The tumor was found to be a well-demarcated solid and multi-cystic lesion without any enhancement, measuring 4 cm in diameter. After 28 months of follow-up, the tumor enlarged. At 31 months after initial diagnosis, the patient underwent surgical resection because it was difficult to clinically determine whether the tumor was malignant or not. Macroscopically, the solid tumor consisted of yellow adipose tissue with a smooth thin capsule confined to the pancreatic uncus. The inner structure of the tumor consisted of multiple cysts with a white nodule between the cysts. Histologically, the solid part and the multi-cystic portion consisted of mature adipose tissue and colonization of dilated pancreatic ducts with mild fibrosis, respectively. Immunohistochemical findings revealed cytokeratin 7 and 19 positive staining in the epithelial cells of the ducts. Adipose tissue showed positive staining for S-100 protein and there were only a few MIB-1 positive cells. The tumor was then diagnosed as a pancreatic hamartoma.ConclusionBeside on the above findings, we suggest that the term “well-demarcated solid and cystic lesion with chronological morphological changes” could be a clinical keyword to describe pancreatic hamartomas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0419-2) contains supplementary material, which is available to authorized users.

Imaging findings for pancreatic Hamartoma: two case reports and a review of the literature

“…Case 1 was a solid lesion with small cystic lesions, and case 2 was a solid lesion. This tumour is characterized by soft tissue masses of different sizes (ranging from 0.3 to 14 cm), while over 50% of cases (29/37) were no more than 3 cm [6,7,[9][10][11][12][13][15][16][17][18][19][20][21][22][23][24]. On US, PH is usually observed as a hypoechoic mass with a clear boundary [11,17,19,21].…”

Benign Tumors and Tumorlike Lesions of the Pancreas

“…Usually presents as a well-demarcated, solid or solid and cystic mass. It is often located in the head of the pancreas 115–119 . Cases with multiple lesions have been reported 115, 116 .…”

Pancreatic hamartoma: a sheep in wolf's clothing

“…However, the rarity of this lesion with a lack of specific findings on pre‐operative investigations usually means that a reliable diagnosis can be achieved only on the operative specimen. Individual case studies consistently report no recurrence of the tumour up to 4 years post‐operatively after complete resection with negative surgical margins . For this reason, a prolonged period of surveillance is thought not to be necessary if a histopathological diagnosis of PH has been achieved with clear resection margins.…”

“…PH is a rare benign lesion most commonly in the head of the pancreas, but has also been described in the body and tail . The tumour affects patients of a broad age spectrum, ranging from neonates to the elderly, with no gender predilection .…”

“…The tumour affects patients of a broad age spectrum, ranging from neonates to the elderly, with no gender predilection . Due to the rising prevalence of cross‐sectional abdominal imaging, an increasing number of PH are being diagnosed incidentally . However, larger lesions may present with abdominal pain, an abdominal mass and/or weight loss .…”