Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2012; 18(13): 1538-1544
Published online Apr 7, 2012. doi: 10.3748/wjg.v18.i13.1538
Pancreatic schwannoma: Case report and an updated 30-year review of the literature yielding 47 cases
Toshiyuki Moriya, Wataru Kimura, Ichiro Hirai, Akiko Takeshita, Koji Tezuka, Toshihiro Watanabe, Masaomi Mizutani, Akira Fuse
Toshiyuki Moriya, Wataru Kimura, Ichiro Hirai, Akiko Takeshita, Koji Tezuka, Toshihiro Watanabe, Masaomi Mizutani, Akira Fuse, First Department of Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan
Author contributions: Moriya T, Kimura W, Hirai I, Takeshita A, Tezuka K, Watanabe T, Mizutani M and Fuse A performed surgery and clinical follow-up; Moriya T analyzed data and wrote the paper.
Correspondence to: Wataru Kimura, MD, First Department of Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. wkimura@med.id.yamagata-u.ac.jp
Telephone: +81-23-6285336 Fax: +81-23-6285339
Received: December 7, 2010
Revised: January 24, 2011
Accepted: January 31, 2011
Published online: April 7, 2012
Abstract

Pancreatic schwannomas are rare neoplasms. Authors briefly describe a 64-year-old female patient with cystic pancreatic schwannoma mimicking other cystic tumors and review the literature. Databases for PubMed were searched for English-language articles from 1980 to 2010 using a list of keywords, as well as references from review articles. Only 41 articles, including 47 cases, have been reported in the English literature. The mean age was 55.7 years (range 20-87 years), with 45% of patients being male. Mean tumor size was 6.2 cm (range 1-20 cm). Tumor location was the head (40%), head and body (6%), body (21%), body and tail (15%), tail (4%), and uncinate process (13%). Thirty-four percent of patients exhibited solid tumors and 60% of patients exhibited cystic tumors. Treatment included pancreaticoduodenectomy (32%), distal pancreatectomy (21%), enucleation (15%), unresectable (4%), refused operation (2%) and the detail of resection was not specified in 26% of patients. No patients died of disease with a mean follow-up of 15.7 mo (range 3-65 mo), although 5 (11%) patients had a malignancy. The tumor size was significantly related to malignant tumor (13.8 ± 6.2 cm for malignancy vs 5.5 ± 4.4 cm for benign, P = 0.001) and cystic formation (7.9 ± 5.9 cm for cystic tumor vs 3.9 ± 2.4 cm for solid tumor, P = 0.005). The preoperative diagnosis of pancreatic schwannoma remains difficult. Cystic pancreatic schwannomas should be considered in the differential diagnosis of cystic neoplasms and pseudocysts. In our case, intraoperative frozen section confirmed the diagnosis of a schwannoma. Simple enucleation may be adequate, if this is possible.

Keywords: Pancreatic schwannoma; Pancreas; Schwannoma; Neurinoma; Resection; Imaging; Enucleation; Prognosis; Cystic