Abstract
We report a very rare case of cholesterin granuloma of the pancreas. A 64-year-old man regularly attended our hospital for treatment of type 2 diabetes. In January 2013, he was admitted for upper abdominal pain after heavy drinking and treated based on a diagnosis of acute pancreatitis. He has been treated for acute pancreatitis in 2004 and 2010. A US study showed a heterogenous and hypoechoic mass, 1 cm in diameter, in the head of the pancreas. CT, MRCP and ERCP studies revealed about 2 cm stenosis of the main pancreatic duct at the head of the pancreas and dilatation of the distal main pancreatic duct. The lower common bile duct was smoothly compressed. The tumor markers of CEA and CA19-9 were within normal ranges. Based on the above findings, the presence of a malignant lesion could not be ruled out, and therefore subtotal stomach-preserving pancreatoduodenectomy (D2, SSPPD-II reconstruction) was performed. Pathohistological examination of the resected specimen showed cholesterin crystals and foreign body giant cells surrounding cholesterin crystals at the center of the tumor and a diagnosis of cholesterin granuloma was made.
