A rare neoplasm of the Pancreas
G Maniyelil, B Chaithanya, S Divya
Citation
G Maniyelil, B Chaithanya, S Divya. A rare neoplasm of the Pancreas. The Internet Journal of Pathology. 2008 Volume 10 Number 1.
Abstract
Schwannomas are tumours that are said to be arising from the neural crest cell, are very common in association with nerves at a superficial location. They are also described in the Retroperitoneum, Mediastinum and a group has been recognized as acoustic schwannomas . Soft tissue tumours as such are rare in the pancreas, the commonest being leiomyoma. Several other benign tumours like benign fibrous histiocytoma, juvenile haemangio endothelioma, granular cell tumour and lymphangioma Here in we report a case of pancreatic schwannoma, a rare location for the tumour.(1) The diagnosis of schwannoma is important because it is the differential diagnosis of many cystic and solid neoplasms of the pancreas.
Introduction
Pancreatic Schwannomas are rare neoplasms (1, 2,3,4,5,6,7) partially cystic which grossly resemble
solid and cystic lesions of pancreas, especially when diagnosed in young females
Case report
A 30 year old lady presented with history of low back pain of one year duration. She was treated
conservatively elsewhere with a diagnosis of pseudo cyst of pancreas and later on transferred to our
centre.
A CT scan showed solid and cystic neoplasm located at the body of the pancreas. With a clinical
diagnosis of cystic neoplasm the patient was operated .
Perioperatively, a well encapsulated cystic lesion found in the body of pancreas, the pancreas appeared
flayed , no other abnormality were found in the surrounding vessels, viscera or organs. A distal
Pancreatectomy with Splenectomy was done.
A well encapsulated cystic lesion at the body of pancreas measuring 7cm in diameter with
surrounding pancreatic tissue was received at the pathology department. On opening cystic and
solid myxoid areas were found. Histopathology confirmed the lesion as Schwannoma with cystic areas. After two years the patient is doing well. No features of multiple neurofibromatosis found in this patient.
A pancreatic shwannoma – bisected B Areas of spindle cell neoplasm with varocay bodies ( C ) S100
protein shows areas both nuclear cytoplasmic positivity
Discussion
Pancreatic schwannomas are rare neoplasms of this organ , leiomyoma being the most commonly
reported one. Most of them present as well encapsulated neoplasms with cut-surface showing solid and
cystic areas .Mostly these neoplasm are encountered in young woman .The differential diagnoses
considered were a mucinous or serous cystadenoma , solid and cystic tumour of the pancreas .The
radiology may not present with a typical appearance , but excision and biopsy is the gold standard in
the diagnosis . The clinches of diagnosis is that it is a benign tumour where surgery is mostly curative
Conclusion
Shwannoma is a rare neoplasm of the pancreas, which can show both solid and cystic areas .It should
be considered in the differential diagnosis of the cystic lesions of pancreas especially in young adults
