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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Schwannoma mimicking pancreatic carcinoma: A case report
Koichi Kimura, Eisuke Adachi, Ayako Toyohara, Sachie Omori, Kaoru Ezaki, Ryo Ihara, Takahiro Higashi, Kippei Ohgaki, Shuhei Ito, Shin-ichiro Maehara, Toshihiko Nakamura, Fumiyoshi Fushimi, Yoshihiko Maehara
Koichi Kimura, Eisuke Adachi, Ayako Toyohara, Sachie Omori, Takahiro Higashi, Kippei Ohgaki, Shuhei Ito, Shin-ichiro Maehara, Toshihiko Nakamura, Yoshihiko Maehara, Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan
Kaoru Ezaki, Ryo Ihara, Department of Internal Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan
Fumiyoshi Fushimi, Department of Histopathology, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan
Author contributions: Kimura K was responsible for the study conception, design and drafting of the manuscript; Toyohara A, Omori S, Ezaki K, Ihara R, Higashi T, Ohgaki K, Ito S, Maehara S, Nakamura T and Fushimi F were responsible for data collection; Adachi E and Maehara Y were responsible for critical revision of the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Koichi Kimura, MD, PhD, Doctor, Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, 3-23-1 Shiobaru, Minamiku, Fukuoka 815-8588, Japan. cubicseal@gmail.com
Received: February 16, 2021
Peer-review started: February 19, 2021
First decision: March 7, 2021
Revised: March 7, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: June 16, 2021
BACKGROUND
Schwannoma of the pancreas is extremely rare. We report a case of pancreatic schwannoma that was difficult to distinguish from pancreatic carcinoma before surgery.
CASE SUMMARY
A 66-year-old male underwent a right-lobe hepatectomy for hepatocellular carcinoma. Post-surgical computed tomography showed a 10 mm long solid mass with ischemia, with no expansion into the main pancreatic duct. Upon magnetic resonance cholangiopancreatography, the tumor had high signal intensity in diffusion weighted images, consistent with pancreatic carcinoma. Endoscopic ultrasound (EUS) was performed to obtain more information about the tumor, and showed a 14 mm solid and hypoechoic mass in the pancreatic body. Contrast enhanced EUS revealed that the tumor showed a hyperechoic mass in the early phase, and the contrasting effect continuation was very short; findings also consistent with pancreatic carcinoma. Thus, we preoperatively diagnosed his condition as a pancreatic carcinoma and performed distal pancreatectomy with splenectomy. Microscopic examination showed that the tumor was in fact a benign schwannoma. Histology showed a proliferation of spindle-shaped cell in a vague fascicular and haphazard pattern, with palisading arrangement.
CONCLUSION
Schwannoma of the pancreas is very rare, however, clinicians should consider schwannoma as the differential diagnosis for pancreatic tumors.
Core Tip: Schwannoma of the pancreas is extremely rare, with 68 cases reported in the literature. On the other hand, preoperative diagnosis of schwannomas can be difficult, as schwannomas have no specific imaging findings, thus the preoperative diagnosis is not easy to confirm. We have experienced a case of schwannoma in pancreatic body mimicking pancreatic carcinoma, and performed surgical treatment. Clinicians should consider nonepithelial tumors as a part of the differential diagnosis for pancreatic tumors despite their low frequency.
