Pancreatic schwannoma: A rare case and a brief literature review

Ercan, Metin; Aziret, Mehmet; Bal, Ali; Şentürk, Adem; Karaman, Kerem; Kahyaoğlu, Zeynep; Koçer, Havva Belma; Bostancı, Birol; Akoğlu, Musa

doi:10.1016/j.ijscr.2016.03.014

Cited by 21 publications

(16 citation statements)

References 16 publications

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“…Pancreatic schwannomas are well-demarcated, encapsulated, homogeneous, tan-yellow, round solid masses on macroscopical examination [ 1 , 3 , 28 , 29 ]. The classic features of pancreatic schwannomas often contain both hypercellular and hypocellular zones on microscopical examination [ 3 , 4 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

MR imaging features of pancreatic schwannoma: a Chinese case series and a systematic review of 25 cases

et al. 2021

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Background There is a paucity of existing literature centering on the magnetic resonance (MR) imaging features of pancreatic schwannomas, due to the neoplasm’s nonspecific presentation and its rarity. We aimed to identify the characteristic imaging features of pancreatic schwannoma. Methods This retrospective search was conducted for histologically confirmed pancreatic schwannoma in multi-institutional database of pathology. Abdominal magnetic resonance imaging (MRI) was performed before histologic examination and their MR imaging studies were independently reviewed. The search yielded six adults (mean age, 46 years) with a definitive histologic postoperative diagnosis of single pancreatic schwannoma each. Additionally, a comprehensive English and Chinese literature review for pancreatic schwannoma and reported MR-imaging findings since 1961 was also conducted. MR imaging features of those cases in the literature were analyzed, summarized and compared with our case series. Results This rare entity appeared to be a well-circumscribed, exophytic, oval or round pancreatic mass with a mean greatest diameter of 3.7 cm. Five schwannomas were located in the pancreatic head-neck and one in the pancreatic tail. On MRI, all cases appeared hypointense on T1-weighted images, inhomogeneous hyperintense on T2-weighted images, and hyperintense on diffusion-weighted images. The mean apparent diffusion coefficient (ADC) values of pancreatic schwannoma were 1.11 ± 0.29 × 10− 3 mm2/s and significantly lower than the surrounding pancreas. The lesion-to-pancreas signal intensity ratio (SIR) at unenhanced T1-weighted images was 0.53 ± 0.07. On dynamic contrast-enhanced MRI, most of the lesions (67%, 4/6) showed homogeneously iso- or hypointense on arterial and portal venous phases, and hyperenhancement on delayed phase compared with the surrounding pancreas. In our analysis of the time intensity curves, all cases exhibited a gradual enhancement pattern. Conclusions A well-circumscribed mass displaying inhomogeneous hyperintensity on T2, marked hypointensity on T1, hyperintensity on DWI, and with early slight enhancement at arterial phase and progressive enhancement at portal venous and delayed phase, may suggest the diagnosis of pancreatic schwannoma.

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Section: Discussionmentioning

confidence: 99%

MR imaging features of pancreatic schwannoma: a Chinese case series and a systematic review of 25 cases

et al. 2021

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“…Pancreaticoduodenectomy (PD) is a standard technique for tumors in the pancreatic head except for small and pedunculated, i.e., easily resectable, benign tumors. An eventful postoperative course was reported in a case of pancreatic head schwannoma treated with PD using a standard Whipple procedure [ 10 ]. We, therefore, initially planned enucleation followed by PD as a second operation just in case of histologically proven malignant tumor on routine histological evaluation.…”

Section: Discussionmentioning

confidence: 99%

Successful Enucleation of a Large Pancreatic Head Schwannoma

Yamaguchi

Oura

Makimoto

2021

Case Rep Gastroenterol

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A presumed benign cystic tumor in the pancreatic head had been pointed out to a 78-year-old man 4 years ago. In addition to no communication between the tumor and the main pancreatic duct, magnetic resonance imaging showed that the cystic fluid was serous. Gradual tumor enlargement from 2.1 to 4.0 cm urged us to resect the tumor. In order to safely enucleate the tumor, we preoperatively placed a pancreatic duct stent and covered the pancreatic parenchyma with a polyglycolic acid sheet, fibrin glue, and thrombin after tumor enucleation. The patient postoperatively developed grade B pancreatic fistula but recovered with antibiotics therapy. Postoperative computed tomography showed successful preservation of the main pancreatic duct. Pathological study showed a well-defined tumor mainly composed of loosely textured and S-100-positive spindle cells with abundant and hyalinized blood vessels in the cystic walls with palisading spindle cells, leading to the diagnosis of Antoni B schwannoma. The patient was discharged on the 11th day after operation. Both pancreatic duct stunting and covering the exposed pancreatic parenchyma with a polyglycolic acid sheet, fibrin glue, and thrombin are feasible measures to enucleate large benign tumors in the pancreatic head.

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“…The Antony A pattern has a spindle-long cell which shows a tight fence and higher cells with nuclear double-sequence field (palisading). The Antony B pattern has a loose distribution of the cells with varying degrees of lipoidization [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

A rare tumour of pancreas—Case report

Krishna

Sivasankar

2020

International Journal of Surgery Case Reports

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Highlights Pancreatic schwannomas are very rare neoplasm arising from Schwann cells that present in the nerve sheath. Approximately only 50 cases reported in the literature. Although the incidence of pancreatic schwannoma is low, it must be considered as one possibility in the differential diagnosis of mass lesions in the pancreas. Whenever possible especially in large tumors surgical resections should be considered as an option due to increased chance of transformation to malignancy.

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Pancreatic schwannoma: A rare case and a brief literature review

Cited by 21 publications

References 16 publications

MR imaging features of pancreatic schwannoma: a Chinese case series and a systematic review of 25 cases

MR imaging features of pancreatic schwannoma: a Chinese case series and a systematic review of 25 cases

Successful Enucleation of a Large Pancreatic Head Schwannoma

A rare tumour of pancreas—Case report

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