Pancreatic Schwanoma Presenting as Gastric Outlet Obstruction- A Rare Presentation

Abstract

Introduction: Schwannoma is a very uncommon pancreatic neoplasms. Because of their varing size, cystic nature they mimic pancreatic cystic neoplasms. Mostly definitive diagnosis is confirmed with histological assessment post resection. The mainstay of treatment is surgical resection based on the nature of tumour. Case presentation: Here we are reporting a very rare case of pancreatic schwannoma in 45 year old female presenting with pain upper abdomen with projectile vomiting. Pre-operative diagnosis of heterogenous tumor arising from head of pancreas was made on CECT abdomen following which Whipple's procedure was performed. Post operative histological analysis showed spindle cells arranged in palisading pattern with S-100 positivity, confirms the diagnosis of pancreatic schwannoma. Conclusion: We conclude that pancreatic schwannoma must be considered as an important differential diagnosis of pancreatic neoplasms. Though they have non specific symptoms but can present in unusual way as gastric outlet obstruction. Pre-operative diagnosis is difficult though computed tomographic and magnetic resonance imaging may be of value. For benign tumors, simple enucleation is enough, while malignant tumors requires complete oncological resection.