Pancreatic lipoma: a pancreatic incidentaloma; diagnosis with ultrasound, computed tomography and magnetic resonance imaging

Abstract

Pancreatic lipomas are rare. We present a case of incidentally discovered pancreatic lipoma in a 45-year-old female suffering from metastatic ovarian carcinoma who was referred to radiology for follow-up imaging. Fat-containing tumours originating from the pancreas are very rare. Most lipomasshow characteristic features on imaging that allow their differentiation. In most cases, accurate diagnosis is attained without any histopathological confirmation. We present the imaging features of pancreatic lipoma on ultrasound, CT scan and MRI, the differential diagnosis and a brief review of the literature.

Figure 1.

Transverse grayscale (B-mode) ultrasound image showing hypo- to isoechoic lesion on the head of the pancreas.

Figure 2.

Non-contrast CT scan shows a well-circumscribed focal lesion (arrow) on the pancreatic head, measuring 35 x 35 x 19 mm and with a density of −106 Hounsfield units, consistent with fatty tissue.

Figure 3.

Contrast-enhanced CT scan shows a homogeneous focal mass (arrow) on the pancreatic head. The mass was isodense with fatty tissue and interlobular septa, and without central or peripheral contrast enhancement (arrow).

Figure 4.

(a) Axial T₂ and (b) T₁ weighted MRI showing a hyperintense lobulated mass (arrows) on the head of the pancreas.

Figure 5.

Axial T₁ weighted fat-suppressed sequence showing suppression of T₁ hyperintensity (black arrow) within the lesion, suggesting a lesion of fatty nature.