Symptomatic pancreatic lipoma managed with a metallic biliary stent: Case report

INTRODUCTION: Mesenchymal tumors comprise only 1 to 2% of all pancreatic tumors, being lipomas a rare variant of mesenchymal tumors of the pancreas. PRESENTATION OF CASE: This is the report of an 82-year-old woman who presented at the medical emergency room in a fourth level clinic with five days of nausea evolution, emesis, jaundice, coluria, acholia, and abdominal pain in the right hypochondrium. Diagnostic imaging and ultrasonography discovered and characterized a significant dilation of the intra and extrahepatic bile duct, caused by the presence of a mass in the head of the pancreas of lipomatous origin. The obstruction was successfully managed with a metallic fully covered removable biliary stent. DISCUSSION: Some studies have reported the incidence of pancreatic lipoma being 0.08% and 0.012%, and the vast majority of them (>95%) are asymptomatic and properly handled without intervention, however, symptomatic tumors require surgical treatment. In our case, the surgical treatment was not suitable because of her multiple comorbidities, cardiovascular risk and advanced age. Our management continued to be a minimally invasive approach, without general anesthesia and good postoperative results. CONCLUSION: To the best of our knowledge we report the first case of symptomatic pancreatic lipoma in Colombia with unique management, and the second in Latin America.