Published online May 28, 2017. doi: 10.3748/wjg.v23.i20.3744
Peer-review started: January 19, 2017
First decision: February 10, 2016
Revised: February 26, 2016
Accepted: March 21, 2017
Article in press: March 21, 2017
Published online: May 28, 2017
Schwannomas are neurogenic tumors that arise from the neural sheaths of peripheral nerves. These tumors can be located in any area of the human body; the most common locations are the head, neck, trunk and extremities. Pancreatic schwannomas are very rare. Over the past 40 years, only 67 cases of pancreatic schwannomas have been reported in the English literature. Here we present a case of pancreatic schwannoma in a 62-year-old male. The tumor was revealed by ultrasound and computed tomography in the neck and body of the pancreas. An accurate diagnosis was difficult to obtain preoperatively. The patient consented to the performance of a laparotomy, and the mass was found in the neck and body of the pancreas and successfully treated using a spleen-preserving distal pancreatectomy with splenic artery and vein preservation. The procedure has only been reported in one other case of pancreatic schwannoma; here we present the second reported case. Macroscopically, the tumor was well circumscribed, gray-white in color and 3.3 cm × 2.8 cm in size. Microscopically, the tumor cells were spindle-shaped and had a palisading arrangement with no atypia, which are results compatible with a benign tumor. Both hypercellular and hypocellular areas were visible. Immunohistochemically, the tumor cells were strongly positive for S-100 protein. The tumor was definitively diagnosed as a schwannoma of the pancreatic neck and body. The patient was followed for 72 mo and has been doing well without any complications.
Core tip: Over the past 40 years, only 67 cases of pancreatic schwannoma have been reported in the English literature. An accurate preoperative diagnosis is difficult to obtain. Here, we present the case of a patient with a pancreatic schwannoma who underwent spleen-preserving distal pancreatectomy. This surgical intervention has only been previously reported in one case of pancreatic schwannoma. After surgery, the patient recovered quickly and had a good prognosis. In this case report, we share our experience in the diagnosis and treatment of a rare pancreatic schwannoma and performed a literature review to deepen the understanding of the subject.