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