A Case of Pancreatic Schwannoma Resection

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 3; pp. 798 - 804
• Main Authors: SHIMIZU, Yoshimasa, KIKUCHI, Yuji, TACHIKAWA, Nobuo, HURUUCHI, Takayuki, HORI, Masao, SAKUMA, Masayoshi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2014
• Subjects: pancreatic schwannoma; pancreatic tumor
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.798

A 45-year-old woman visited our hospital because of the presence of an abdominal tumor on palpation. Abdominal CT showed a low-density, well-circumscribed mass in the pancreas head measuring 8 cm in diameter. MRI of the pancreas revealed a hypointense mass on T1-weighted images and a hyperintense mass on T2-weighted images. Magnetic resonance cholangio-pancreatography showed no marked change in the main pancreatic duct and common bile duct. Angiography showed tumor vascularization with the superior anterior and posterior pancreaticoduodenal arteries as the feeders. We preoperatively diagnosed the condition as a solid pseudopapillary tumor from the pancreas and performed a pancreatoduodenectomy. The tumor was solid, with strong myxomatous degeneration with a film-forming of 80 mm in the histopathological exam. Histopathology of the pancreatic tumor also revealed a schwannoma and no sign of malignancy. S-100 protein was detected by a immunohistochemical stain. Pancreatic schwannoma is very difficult to diagnose preoperatively. In cases of pancreatic schwannoma, surgical resection should be considered because of the possibility of malignancy.