Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2023; 11(23): 5615-5621
Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5615
Pancreatic cavernous hemangioma complicated with chronic intracapsular spontaneous hemorrhage: A case report and review of literature
Ting Li
Ting Li, Department of Radiology, Yongkang First People’s Hospital, Yongkang 321300, Zhejiang Province, China
Author contributions: Li T conceived and designed the research, reviewed the medical records and collected data, wrote the manuscript, read and approved the final version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of images and data included in this article.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ting Li, MM, Doctor, Department of Radiology, Yongkang First People’s Hospital, No. 599 Jinshan West Road, Yongkang 321300, Zhejiang Province, China. 702425634@qq.com
Received: June 8, 2023
Peer-review started: June 8, 2023
First decision: July 4, 2023
Revised: July 11, 2023
Accepted: July 25, 2023
Article in press: July 25, 2023
Published online: August 16, 2023
Processing time: 69 Days and 3.4 Hours
Abstract
BACKGROUND

Pancreatic cavernous hemangioma (pCH) is a rare type of benign vascular tumor. Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.

CASE SUMMARY

We describe a male patient, age 18, who presented with a pCH. Computed tomography, magnetic resonance imaging, and ultrasound showed cystic space in the tail of the pancreas. A dark spot sign on the T2 weighted image sequence was observed. Clinically, a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging, and the operative indication was clear. The patient underwent a distal pancreatic tumor resection under laparoscopic control. Immunohistochemical staining for CD31 and CD34 was positive; D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells; and calcium-binding protein was negative. The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage. No complications or recurrences were observed during the follow-up period.

CONCLUSION

Chronic spontaneous hemorrhage may occur in pCH, which may greatly influence the accuracy of diagnosis using imaging modalities. Surgical resection for uncertain pCH seems reasonable with a good outcome.

Keywords: Pancreatic cavernous hemangioma; Magnetic resonance imaging; Diagnosis; Chronic spontaneous hemorrhage; Case report

Core Tip: Pancreatic cavernous hemangioma (pCH) is a rare type of benign vascular tumor, which is difficulty to correctly diagnose. The imaging features of pCH differ among the different cases. Herein, we present an 18-year-old male patient who was diagnosed with pCH after surgical resection. On the T2-weighted image of the magnetic resonance imaging, a dark spot sign was observed. The sign represented chronic intracapsular hemorrhage and was not reported before. We hope this case can help us gain knowledge about diagnosing pCH accurately.