AI Article Synopsis
- - Pancreatic schwannomas are rare tumors that often resemble pancreatic cystic lesions on imaging, with diagnosis usually confirmed during surgery after biopsy.
- - A case report details a 69-year-old woman with a pancreatic mass identified via CT scan, confirmed as schwannoma through biopsy, but surgical removal was not possible due to its complex relationship with surrounding blood vessels.
- - Only 24 cases of pancreatic schwannoma have been recorded, with most being benign; surgical removal is generally curative, though the effectiveness of radiation therapy for non-resectable tumors remains uncertain.
Article Abstract
Context: Pancreatic schwannomas are rare neoplasms. These tumors vary in size and two thirds are partially cystic which grossly mimic pancreatic cystic lesions. Computed tomography and magnetic resonance imaging are the primary initial imaging modalities. Definitive diagnosis is typically made at the time of laparotomy following biopsy. Surgical resection is the mainstay of treatment.
Case Report: A 69-year-old woman presented with abdominal pain in the epigastric and left upper quadrant. The patient had no systemic symptom and laboratory results including tumor markers were negative. A CT scan of the abdomen showed a 5 cm mass arising from the head of the pancreas. Needle biopsy revealed a mass consistent with schwannoma. At laparotomy, a large pancreatic head mass was found to encase the superior mesenteric artery, and portal vein confluence. Frozen biopsy showed schwannoma. Curative resection was deferred due to extensive vascular involvement and favorable tumor biology. A gastrojejunostomy was performed and radiation therapy was instituted post-operatively.
Conclusions: Only 24 cases of pancreatic schwannoma had been previously reported. Definitive diagnosis is obtained with routine histology. Most tumors are benign and surgical resection is curative. The role of radiation therapy in the management of unresectable tumors is still unclear.
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