Pancreatic cancer complicated with a giant peritoneal loose body: case report and literature review

This paper reports a case of an 82-year-old male with a giant peritoneal loose body (GPLB) complicated by pancreatic head cancer. The patient was admitted for upper abdominal pain and jaundice. CT revealed a 5.5 × 5.6 cm oval low-density mass on the right side of the pelvis with a central high-density calcified focus, initially diagnosed as a gastrointestinal stromal tumor. During surgery, a yellow free mass measuring 6 × 6 × 5 cm was found in the pelvic cavity; pathology confirmed that it was a peritoneal loose body. Grossly, it was yellow and ovoid, with central calcification on the cut surface; microscopically, necrotic adipose tissue and hyalinized collagen fibers were visible. Meanwhile, we comprehensively reviewed and analyzed 32 previously reported cases of GPLB, summarizing the disease characteristics, clinical manifestations, formation mechanisms, diagnostic approaches, and treatment strategies. We propose a hypothesis-generating observation that abnormal liver and kidney function may accelerate the growth rate of giant peritoneal loose bodies. We also recommend that surgical removal be performed regardless of whether symptoms are present, with laparoscopy as the preferred procedure. This study aims to improve clinicians’ understanding of this disease and reduce misdiagnosis.