Pancreatic panniculitis associated with pancreatic carcinoma

Zhang, Guannan; Cao, Zhe; Yang, Gang; Wu, Wenming; Zhang, Taiping; Zhao, Yupei

doi:10.1097/md.0000000000004374

Cited by 17 publications

(12 citation statements)

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“…Focal calcification and anuclear adipocytes, within a thick, shadowy wall (ghost cells) are characteristic [ 12 ]. Laboratory investigations usually reveal raised amylase, lipase and trypsin levels and sometimes the presence of elevated tumor marker levels, especially carcinoembryonic antigen [ 13 ]. Interestingly, in the first patient, elevated lipase were found even though he had normal amylase.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic panniculitis: the “bright” side of the moon in solid cancer patients

et al. 2018

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BackgroundPancreatic panniculitis is a rare complication of pancreas disorders occurring in 0.3–3% of patients, most often accompanied by the pancreatic acinar carcinoma.It presents multiple, painful, deep, ill-defined, red-brown, migratory nodules and plaques of hard elastic consistency; often ulcerated and typically located on the lower proximal and distal extremities.The pathogenesis is not fully understood, but it is thought to result from lipolysis and fat necrosis with secondary tissue inflammation induced by pancreatic enzymes. Histopathology shows subcutaneous lobular fat necrosis with anuclear adipocytes (called ghost cells) surrounded by a mixed inflammatory infiltrate. Focal calcification may also be seen. The treatment is directed to the underlying disorder, which may result in regression of skin lesions.Case presentationWe present two cases of pancreatic panniculitis with similar clinical, laboratory, and histopathological features associated with different internal malignancy. The first case, after extensive investigations showed the presence of a pancreatic carcinoma with multiple liver metastases and a poor prognosis. The second one instead is the first case in literature where painful subcutaneous nodules of the legs were the early manifestation of a neuroendocrine carcinoma of the adrenal gland.ConclusionsAlthough subcutaneous fat necrosis usually occurs late in the course of a malignancy, recognition of the association with pancreatic panniculitis may prevent a long delay in the diagnosis and management of the occult neoplasm. It should be primarily considered when panniculitis is widespread and persistent, and frequent relapses or tendency to ulcerate of the nodules are regarded as red flags.

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Section: Discussionmentioning

confidence: 99%

Pancreatic panniculitis: the “bright” side of the moon in solid cancer patients

et al. 2018

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“…It results from fat necrosis in the subcutaneous tissue usually of the extremities, and presents as erythematous nodules which may ulcerate and exudate. There are several case reports and literature reviews on PP describing its association with both benign and malignant pancreatic pathology [ 9 ].…”

Section: Cutaneous Manifestations In Pancreatic Diseasesmentioning

confidence: 99%

Cutaneous Manifestations in Pancreatic Diseases—A Review

Miulescu

Balaban

Şandru

et al. 2020

JCM

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Pancreatic pathology, comprising acute and chronic pancreatitis, autoimmune pancreatitis and pancreatic neoplasms, primarily presents with gastrointestinal symptoms and signs; however, it is well recognized that it can also associate a wide range of extra-digestive features. Among these systemic manifestations, cutaneous involvement plays an important role both as a diagnostic clue for the pancreatic disease itself and serving as a prognostic factor for the severity of the condition. Recognition of these cutaneous signs is, however, far from being satisfactory, all the more as some of them are relatively rare. In the current review, we discuss skin involvement in pancreatic diseases, referring to pancreatic panniculitis, cutaneous hemorrhagic manifestations, skin metastasis, acanthosis nigricans, livedo reticularis, necrolytic migratory erythema and cutaneous fistula. We highlight the clinical characteristics, treatment and prognostic value of these lesions. Better awareness among medical specialties other than dermatology is needed for detection of the skin clues associated with pancreatic pathology.

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“…Pancreatic panniculitis is a rare cause of subcutaneous fat necrosis in patients with pancreatic acinar cell carcinoma: it has also rarely been associated with other pancreatic malignancies and chronic pancreatitis. 1 Here, we describe a case of pancreatic panniculitis associated with a rare cause of hyperlipasemia.…”

Section: Introductionmentioning

confidence: 96%