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Case Reports
. 2016 Aug;95(31):e4374.
doi: 10.1097/MD.0000000000004374.

Pancreatic panniculitis associated with pancreatic carcinoma: A case report

Guannan Zhang  1 , Zhe Cao, Gang Yang, Wenming Wu, Taiping Zhang, Yupei Zhao
Affiliations
Case Reports

Pancreatic panniculitis associated with pancreatic carcinoma: A case report

Guannan Zhang et al. Medicine (Baltimore). 2016 Aug.

Abstract

Introduction: Pancreatic panniculitis is a very rare complication of pancreatic cancer, most often accompanying rare acinar cell carcinoma. We herein report a case of pancreatic panniculitis that was associated with pancreatic mucinous adenocarcinoma.

Patient information: A 57-year-old male was referred to our hospital for weight loss. A physical examination revealed subcutaneous nodules on his lower extremities. The blood test showed abnormal increases in amylase, lipase, and carbohydrate antigen 19-9 levels. A computed tomography scan detected a hypodense 2 × 1.5 cm solid mass with an unclear margin in the head of the pancreas. The biopsy of subcutaneous nodules on the lower extremities was conducted and revealed lobular panniculitis. Pancreatic cancer and pancreatic panniculitis were strongly suspected. After the administration of octreotide acetate and the Whipple procedure, the serous amylase and lipase levels returned to normal, and the pancreatic panniculitis had almost resolved by 4 weeks later.

Conclusion: Pancreatic panniculitis is a rare complication of pancreatic cancer. However, in the presence of a pancreatic mass, as in this case, clinicians should be aware that panniculitis may be the sentinel of pancreatic carcinoma.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Subcutaneous nodule on the lower extremities. (A) Tender erythematous subcutaneous nodules on the lower extremities; (B) necrosis with nuclear debris and “ghost” cells’ characterized by anucleated adipocytes with partially digested shadowy cell membranes.
Figure 2
Figure 2
Imaging findings from the pancreatic tumor. (A) Computed tomography detected a 2 × 1.5 cm hypodense solid mass with an unclear margin in the head of the pancreas; (B) expanded primary pancreatic duct and the cystic low density in the tail of pancreas; (C) cystic low density in the uncinate process of the pancreas; (D) PET-CT revealed a malignant mass in the pancreatic head.
Figure 3
Figure 3
Pathological findings (hematoxylin/eosin staining): pancreatic mucinous adenocarcinoma.
See this image and copyright information in PMC

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