Pancreatic schwannoma: Case report and an updated 30-year review of the literature yielding 47 cases

Table 1 Summary of cases with pancreatic schwannoma

Author	Year	Sex	Age	Presenting symptoms	Size(cm)	Location	Solid/cystic by image	Treatment	Histology	Follow-up (mo)
Current case	2010	F	64	Asymptomatic	4.0	Uncinate	Solid and cystic	Enucleation	Benign	65
Dorsey et al[6]	2010	F	54	Abdominal pain, weight loss	1.4	Head	Solid	NA	Benign	NA
Stojanovic et al[7]	2010	F	24	Abdominal pain, dyspepsia, weight loss, palpable tumor	18.0	Body/tail	Cystic	DP + transverse colon	Malignant	28
Suzuki et al[8]	2010	F	66	Asymptomatic	3.0	Body	Solid and cystic	DP	Benign	24
Aggarwal et al[9]	2010	M	20	Upper abdominal discomfort	3.0	Head	NA	Enucleation	Benign	NA
Ohshima et al[10]	2010	F	32	Back pain	4.0	Head	Solid and cystic	PD	Benign	NA
Mummadi et al[11]	2009	M	35	Epigastric pain	7.0	Body	Solid and cystic	NA	Benign	6
Gupta et al[5]	2009	F	56	Asymptomatic	8.3	Head/body	Cystic	PD	Benign	NA
Li et al[12]	2009	M	37	Asymptomatic	16.0	Head	Solid and Cystic	PD	Benign	NA
Tafe et al[13]	2008	M	46	Abdominal pain	11.0	Body/tail	Cystic	DP	Benign	NA
Hirabayashi et al[14]	2008	M	51	Asymptomatic	6.0	Tail	Cystic	DP	Benign	NA
Okuma et al[15]	2008	F	71	Epigastric pain	4.0	Body	Solid and cystic	DP	Benign	NA
Tofigh et al[16]	2008	M	54	Epigastric pain, weight loss, nausea, intermittent jaundice	3.0	Head	Solid (by specimen)	PD	Benign
Fasanella et al[17]	2007	M	36	Abdominal discomfort	3.6	Uncinate	Cystic	NA	Benign	NA
Di Benedetto et al[18]	2007	M	42	Asymptomatic	2.5	Body	Solid	DP	Benign	NA
Yu et al[19]	2006	M	72	Upper abdominal pain	1.0	Head/body	Solid	NA	Benign	NA
Wu et al[20]	2005	M	71	Epigastric pain, decreased appetite	1.5	Head	Cystic	Enucleation	Benign	10
Novellas et al[21]	2005	F	46	Asthenia, weight loss, empyema	3.0	Head	Solid	PD	Benign	24
Soumaoro et al[22]	2005	F	64	Asymptomatic	2.5	Head	Solid	Enucleation	Benign	24
Bui et al[23]	2004	F	69	Abdominal pain	5.0	Head	Solid	Unresectable	NA1	NA
Akiyoshi et al[24]	2004	F	67	Asymptomatic	5.0	Head	Cystic	PD	Benign	43
Von Dobschuetz et al[25]	2004	F	55	Asymptomatic	8.0	Head	Cystic	PD + PV reconstruction	Benign	10
Paranjape et al[4]	2004	F	77	Upper abdominal pain, weight loss	3.5	Body	Solid	Enucleation	Benign	3
Tan et al[26]	2003	F	46	Right upper quadrant pain	2.2	Head	Solid and Cystic	PD	Benign	NA
Almo et al[2]	2001	F	73	Abdominal pain, nausea, vomiting	3.0	Head	Cystic	PD	Benign	17
Almo et al[2]	2001	F	47	Abdominal pain, back pain	5.5	Head	Solid	PD	Benign	14
Lee et al[27]	2001	F	63	Upper abdominal pain	10.0	Tail	Cystic	DP	Benign	6
Morita et al[28]	1999	F	50	Upper abdominal pain	9.5	Body/tail	Cystic	DP	Benign	7
Brown et al[29]	1998	M	52	Asymptomatic	5.5	Body	Cystic	Resection2	Benign	NA
Brown et al[29]	1998	M	69	Asymptomatic	6.0	Head	Cystic	PD	Benign	NA
Hsiano et al[30]	1998	F	70	Palpable tumor	18.0	Body/tail	Cystic	Resection2	Benign	24
Feldman et al[31]	1997	M	63	Asymptomatic	2.5	Body	Solid	Enucleation	Benign	NA
Feldman et al[31]	1997	F	54	Abdominal pain	2.0	Uncinate	Solid	Enucleation	Benign	22
Ferrozzi et al[32]	1995	M	47	Right-sided abdominal pain	3.5	Body	NA	DP	Benign	48
Ferrozzi et al[32]	1995	M	63	Abdominal pain	NA	Body	Cystic	NA	Benign	NA
Ferrozzi et al[32]	1995	F	68	Upper abdominal pain	NA	Head/body	Cystic	NA	Benign
Sugiyama et al[33]	1995	M	41	Asymptomatic	1.5	Uncinate	Cystic	PD	Benign	NA
Steven et al[34]	1994	M	59	Asymptomatic	4.0	Uncinate	Solid	PD	Benign	10
Melato et al[35]	1993	M	87	Upper abdominal pain	20.0	Body/tail	Cystic	NA	Benign	NA
David et al[3]	1993	M	46	Right sided abdominal pain	6.0	Uncinate	Cystic	NA	Benign	NA
Urban et al[36]	1992	F	56	Right sided hip pain	4.0	Body	Cystic	DP	Benign	NA
Burd et al[37]	1992	M	73	Right upper quadrant abdominal pain	2.0	Body/tail	Solid	NA	Benign	NA
Coombs et al[38]	1990	F	74	Anemia, melena	7.0	Head	Solid with necrotic center	NA	Malignant	NA
Liessi et al[39]	1990	F	75	Abdominal pain	7.0	Head	Solid	Not resected	Benign	7
Walsh et al[40]	1989	F	35	Abdominal pain, melena, anemia	NA	Head	NA	PD	Malignant	24
Eggermont et al[41]	1987	F	40	Upper abdominal pain, jaundice, weight loss	10.0	Head	Solid with necrotic center	PD	Malignant	9
Moller-Pederson et al[42]	1982	M	60	Back pain, weight loss	20.0	Body/tail	Cystic	Unresectable	Malignant	4

M: Male; F: Female; NA: Not available.

¹Unresectable because of encasing the superior mesenteric artery and the portal vein, although the malignant finding was not confirmed by histopathology;

²No specific operation documented.

Table 2 Summary of clinicopathological data from all 47 cases of pancreatic schwannoma

	n (%) or mean ± SD (range)
Age (yr)	55.7 ± 15.1 (20-87)
Sex (male/female), (male %)	21/26 (45%)
Symptoms1
Asymptomatic	14 (30%)
Symptomatic
Abdominal pain	27 (57%)
Weight loss	6 (13%)
Back pain	3 (6%)
Nausea/vomiting	2 (4%)
Abdominal mass	2 (4%)
Anemia	2 (4%)
Melena	2 (4%)
Jaundice	1 (4%)
Location
Head	19 (40%)
Head/body	3 (6%)
Body	10 (21%)
Body/tail	7 (15%)
Tail	2 (4%)
Uncinate process	6 (13%)
Mean size (cm), (n = 44)	6.2 ± 5.1 (1-20)
Operation
Pancreaticoduodenectomy2	15 (32%)
Distal pancreatectomy3	10 (21%)
Enucleation	7 (15%)
Unresectable	2 (4%)
Refused	1 (2%)
Not specified	12 (26%)
Histology
Malignant	5 (11%)
Benign	41 (87%)
Not specified	1 (2%)
Nature of tumor
Solid	16 (34%)
Cystic	28 (60%)
Not specified	3 (6%)
Mean follow-up months (n = 23)	18.9 ± 15.7 (3-65)
Died of disease	0 (0%)

¹Patients had several symptoms;

²One patient underwent resection of portal vein;

³One patient underwent resection of transverse colon.