A case of invasive hemolymphangioma of the pancreas

Abstract

Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy r e ve a l e d b l e e d i n g a t t h e d u o d e n u m . C o m p u t e d tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding.

Ultrasonography of the Pancreas

“…The most frequent of these pancreatic tumors is lymphangioma. All ages are affected and a female predominance is noted [117]. All ages are affected and a female predominance is noted [117].…”

Cystic lymphangioma of the pancreas

“…The cystic and cavernous types have been reported in the pancreas 3 . A rare case has been reported to extend into the duodenal wall, causing gastrointestinal bleeding 4 …”

Contrast-enhanced Ultrasound Findings of Hemolymphangioma of the Kidney: The First Report in the Literature

“…Hemolymphangioma is very rare, and few cases occurring in the rectum, spleen, pancreas, liver have been reported [1][2][3][4][5][6]. Hemolymphangioma often arises from congenital malformation of vascular and lymphatic system.…”