Subcutaneous and Intraosseous Fat Necrosis Associated with Chronic Pancreatitis

Abstract

Background: Extra-abdominal manifestations of fat necrosis, like subcutaneous fat necrosis, polyarthritis, and polyserositis may appear with an occurrence rate of about 0.8%, wherein intraosseous fat necrosis is a more rare complication of pancreatitis, with few reports in English literature. Case report: A 34-year-old male with a 15-year-history of alcohol abuse was hospitalized several times in the last few years because of attacks of relapsed chronic pancreatitis. After the last attack, pancreatitis came in a stable state (“burned out”) with no symptoms and signs of the disease. The patient had been free of symptoms for 28 months since the last admission when he came with sub-febrile temperature, huge pain, swelling, and erythema in the area of the left lateral malleolar region with propagation in the foot. Blood biochemistry was normal. Conventional radiography showed multiple sites of osteolysis in the left calcaneus. Images on multislice computed tomography (MSCT) with 3D reconstruction revealed hypodense focuses that corresponded to osteonecrosis areas and bone marrow edema in the left calcaneus. Conclusions: The possibility of intraosseous fat necrosis should be considered in situations of unexplained polyarthritis or panniculitis, particularly in individuals with alcohol abuse or pancreatic disease.

Membranous fat necrosis of gall bladder, a case report and literature review

“…Despite MFN rarity in intra-abdominal lesions, it is commonly reported in pancreatitis patients. Enzymic fat necrosis, also known as intra-abdominal fat necrosis, is the characteristic diagnosis of pancreatic disorders [ [3] , [4] , [5] , [6] ]. Furthermore, there are some reports of microcytic MFN in appendix epiploica manifested by calcified fibrous nodules on the colon surface or in the abdominal cavity [ 11 ].…”

“…Furthermore, there are some reports of microcytic MFN in appendix epiploica manifested by calcified fibrous nodules on the colon surface or in the abdominal cavity [ 11 ]. Nonetheless, MFN or lipo-membranous fat necrosis is commonly reported in subcutaneous and connective tissue such as dermal lesions, breast lumps, and osteodysplastic disorders [ 6 , 7 , 11 ].…”

“…Scarcely, MFN is found in breast lesions, lipoma, ovarian teratoma, intra-articular loose bodies, cardiac valves, and appendices epiploicae [ 1 , 2 ]. Moreover, there are some reports of MFN findings in pancreatitis patients [ [3] , [4] , [5] , [6] , [7] ]. Obesity, diabetes mellitus, and circulatory disorders are mostly associated with MFN.…”

The Impact of Chronic Pancreatitis on the Occurrences of Human Cancers: Real-World Data

“…Chronic pancreatitis (CP) is a chronic inflammatory disease of the pancreas that could lead to irreversible damage to the pancreatic tissues and to associated exocrine and endocrine insufficiency [1][2][3][4][5]. The diagnosis of CP relies on a combination of image findings that indicate irreversible damage to the pancreas, such as calcification, stones, and duct stricture or dilation, along with manifested exocrine and endocrine dysfunctions [6].…”