A ventriculoperitoneal shunt is a commonly performed procedure that is used to relieve the increased intracranial pressure in patients with hydrocephalus. VP shunt placement is an invasive procedure and carries many complications. Besides common complications like infections or mechanical obstruction, VP shunt has been found to be associated with the development of ascites in some patients. VP shunt-associated ascites is a very rare complication and only a few cases have been reported in the literature, most of which were in the pediatric population, while adult VP shunt-associated ascites was even rarer. The patient in this case is a 32-year-old female who presented with ascites of unclear etiology. She had a history of VP shunt placement shortly after birth due to central nervous system (CNS) malformation (agenesis of the corpus callosum). Liver pathology, infection, and malignancy were ruled out as potential causes, and ascites was determined to be due to VP shunt drainage. The exact mechanism of development of ascites in these patients is not fully understood and needs to be investigated further to optimize preventative and therapeutic options.
Pancreatic schwannoma is a neuroendocrine cell tumor that arises in the pancreas. It is very rare, and, to date, only fewer than 70 similar cases have been reported in the literature. Here, we present another case of this type of tumor in a 68-year-old female.In addition to describing the pancreatic schwannoma, we discuss the major challenges associated with its diagnosis and management. As such, clinically and on imaging, pancreatic schwannomas are almost indistinguishable from other cancerous or benign pancreatic tumors. Therefore, only a biopsy can definitively diagnose pancreatic schwannomas by demonstrating spindle-shaped cells with immunohistochemistry positive for S-100.Because pancreatic schwannomas are very rare, it is important to increase awareness among clinicians about this condition and inform them regarding the challenges associated with its diagnosis and management.
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