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  • The Internet Journal of Pathology
  • Volume 10
  • Number 1

Original Article

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

References

1. Rarepresentation of pancreatic schwannoma: a case report
Arash Mohammadi Tofigh, Mohammad Hashemi, Behzad Nemati Honar, Fereidoon Solhjoo J Med
Case Reports. 2008; 2: 268
2. Cystic pancreatic schwannoma in a 46-year-old man, L Tafe, A. Suriawinata Annals of Diagnostic Pathology, Volume 12, Issue 4, Pages 296-300
3. Pancreatic schwannoma: an uncommon but important entity, Almo K.M.; Traverso L.W Journal of Gastrointestinal Surgery, Volume 5, Number 4, July 2001 , pp. 359-363(5)
4. Pancreatic schwannoma : Report of two cases and review of the literature. Feldman L. ; Philpotts L. E. ; Reinhold C. ; Duguid W. P. ; Rosenberg Pancreas 1997, vol. 15, no1, pp. 99-105 (26
5. Benign schwannoma of the pancreas Soumaoro LT, Teramoto K, Kawamura T, Nakamura N, Sanada T, Sugihara K, Arii S. J Gastrointest Surg. 2005 Feb;9 (2):288-90
6. Pancreatic Schwannoma. Report of a Case.
Morita S Surgery Today vol: 29 issue: 10 page: 1093-1097 year: 1999

Author Information

Govindan Jayasree Maniyelil, MD , DNB ( Pathology)
Department of Pathology , Amrita Institute of Medical Sciences ,Kochi, KERALA ,India

Buva Swapnali Chaithanya, MBBS
Department of Pathology , Amrita Institute of Medical Sciences ,Kochi, KERALA ,India

Surendran Divya, MBBS
Department of Pathology , Amrita Institute of Medical Sciences ,Kochi, KERALA ,India

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