Published online Sep 7, 2015. doi: 10.3748/wjg.v21.i33.9793
Peer-review started: April 7, 2015
First decision: April 23, 2015
Revised: May 29, 2015
Accepted: June 26, 2015
Article in press: June 26, 2015
Published online: September 7, 2015
Pancreatic hemangioma is a rare type of benign vascular tumor. Low clinical suspicion and inability of current cross sectional imaging techniques to differentiate it from other pancreatic lesions, contribute to the difficulty in making the correct diagnosis. Without a definitive diagnosis, and due to concern for malignancy, in many instances, surgery is performed. We report a case of pancreas cavernous hemangioma in an 18-year-old female. The patient presented with three-month history of epigastric pain. Physical examination and routine blood tests were normal. Abdominal Computed Tomography scan revealed a 5 cm × 6 cm complex non-enhancing cystic mass in the head of pancreas. Magnetic resonance imaging, endoscopic ultrasonography (EUS) and EUS guided fine needle aspiration cytology were non-diagnostic. Because of uncontrolled symptoms, the patient underwent surgical resection. Histopathology and Immunohistochemical staining confirmed the diagnosis of cavernous hemangioma of pancreas.
Core tip: Pancreas hemangioma is a very rare pathological finding in adulthood. It may mimic other more common pancreatic lesions. Diagnosis is difficult, due to its rarity, and the absence of typical radiological findings of hemangioma. It should be considered in the differential diagnosis of cystic, mixed and solid pancreatic lesions. Surgical resection is the effective treatment in symptomatic cases, while providing a final diagnosis, however, surgery may not be necessary at all.