Successful treatment of pancreatic schwannoma by enucleation

Abstract

Rationale: Pancreatic schwannomas are extremely rare and are difficult to diagnose preoperatively. Over the past 50 years, only 96 cases of pancreatic schwannoma have been reported in English literature. Herein, we report a case of pancreatic schwannoma treated with enucleation.Patient concerns: A 66-year-old woman visited a local hospital due to ventosities. Ultrasonography and computed tomography revealed a pancreatic mass. She visited our hospital for further diagnosis and treatment.Diagnosis and interventions: Magnetic resonance imaging revealed a tumor in the pancreatic body, and a solid pseudopapillary tumor was considered preoperatively. During the surgery, a pancreatic mass was found growing in the pancreatic body and tail. A successful tumor enucleation was performed. The mass was 7 Â 6 Â 3 cm in size with a thin capsule. Pathological examination revealed that the tumor was mainly composed of spindle-shaped cells with a palisading arrangement and no atypia. Both hypercellular and hypocellular areas were visible. Immunohistochemical staining showed that protein S-100 was strongly positive. The tumor was diagnosed as a benign schwannoma originating from the pancreatic body and tail.Outcomes: Postoperatively, the patient showed good recovery. During the 24-month follow-up period, the patient remained well and free of complications.Lessons: Pancreatic schwannomas are extremely rare and difficult to diagnose using imaging examinations. Enucleation is a safe and efficacious treatment for exophytic pancreatic schwannomas.

Pancreatic schwannoma: a rare tumor of the pancreas

“…Histologically, schwannomas contain various proportions of Antoni A (hypercellular component) and Antoni B (hypocellular component), expressing S-100 protein (1,2,3,4). Surgery is the curative treatment for symptomatic patients and surveillance may be a favorable option for asymptomatic ones, although preoperative diagnosis is challenging (4,5). Following complete tumor excision, patients with pancreatic schwannomas generally exhibit favorable prognosis (2,5).…”

“…Surgery is the curative treatment for symptomatic patients and surveillance may be a favorable option for asymptomatic ones, although preoperative diagnosis is challenging (4,5). Following complete tumor excision, patients with pancreatic schwannomas generally exhibit favorable prognosis (2,5). Immunohistochemical staining of S-100 protein was positive (×100).…”