A Rare Case of Cystic Schwannoma of the Portal Triad

Dimitrios Avgerinos, Meshach Heenatigala, Andrew Lo

Abstract


Schwannomas can occur anywhere throughout the body and
have often been mistaken for more-sinister lesions, especially
when found in relation to the pancreas. Clinical symptoms
range from none to vague abdominal pain, back pain,
anorexia, weight loss, vomiting, jaundice, and episodes of
cholangitis and gastrointestinal bleeding. Preoperative diagnosis
is difficult, and endoscopic ultrasound with fine-needle
aspiration is often limited in specificity. Given the low statistical
likelihood of schwannomas, therapy is usually targeted at the
possibility of pancreatic cystadenoma/cystadenocarcinoma.
Simple enucleation is usually the preferred treatment, and
diagnosis can be established at the time of operation by frozen
section. Schwannomas can be malignant, but preoperative
imaging and pathology can help establish the benign nature
of most specimens. Patients typically do well with resolution of
symptoms. Here we present the case of a patient with abdominal
pain and a peripancreatic mass observed with computed
tomography, who was found to have a cystic schwannoma
extending from the portal triad. The mass was removed and
the patient was discharged without complications.


Keywords


schwannoma; portal triad; cyst; pancreas;

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DOI: http://dx.doi.org/10.23861/EJBM20122815

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