American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: http://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
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American Journal of Clinical Medicine Research. 2014, 2(1), 4-7
DOI: 10.12691/ajcmr-2-1-2
Open AccessCase Report

Pancreatic Schwannoma Presenting as Gastric Outlet Obstruction- A Rare Presentation

Kumar Jayant1, , Swati Agrawal2 and Rajendra Agarwal3

1Department of Surgery, Sudha Hospital &Medical Research Centre, Talwandi, Kota, Rajasthan, India

2Sudha Hospital & Medical Research Centre Kota, Rajasthan, India

3Department of Surgery, Sudha Hospital &Medical Research Centre Kota, Rajasthan, India

Pub. Date: January 16, 2014

Cite this paper:
Kumar Jayant, Swati Agrawal and Rajendra Agarwal. Pancreatic Schwannoma Presenting as Gastric Outlet Obstruction- A Rare Presentation. American Journal of Clinical Medicine Research. 2014; 2(1):4-7. doi: 10.12691/ajcmr-2-1-2

Abstract

Introduction: Schwannoma is a very uncommon pancreatic neoplasms. Because of their varing size, cystic nature they mimic pancreatic cystic neoplasms. Mostly definitive diagnosis is confirmed with histological assessment post resection. The mainstay of treatment is surgical resection based on the nature of tumour. Case presentation: Here we are reporting a very rare case of pancreatic schwannoma in 45 year old female presenting with pain upper abdomen with projectile vomiting. Pre-operative diagnosis of heterogenous tumor arising from head of pancreas was made on CECT abdomen following which Whipple's procedure was performed. Post operative histological analysis showed spindle cells arranged in palisading pattern with S-100 positivity, confirms the diagnosis of pancreatic schwannoma. Conclusion: We conclude that pancreatic schwannoma must be considered as an important differential diagnosis of pancreatic neoplasms. Though they have non specific symptoms but can present in unusual way as gastric outlet obstruction. Pre-operative diagnosis is difficult though computed tomographic and magnetic resonance imaging may be of value. For benign tumors, simple enucleation is enough, while malignant tumors requires complete oncological resection.

Keywords:
pancreatic tumor pancreatic schwannoma schwannoma

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References:

[1]  Almo KM, Traverso LW. Pancreatic schwannoma: an uncommon but important entity. J Gastrointest Surg 2001; 5: 359-363.
 
[2]  Gupta A, Subhas G, Mittal VK, Jacobs MJ. Pancreatic schwannoma: literature review. J Surg Educ 2009; 66: 168-173.
 
[3]  Suzuki S, Kaji S, Koike N, Harada N, Hayashi T, Suzuki M, Hanyu F, Ban S. Pancreatic schwannoma: a case report and literature review with special reference to imaging features. JOP 2010; 11: 31-35.
 
[4]  Mummadi RR, Nealon WH, Artifon EL, Fleming JB, Bhutani MS. Pancreatic Schwannoma presenting as a cystic lesion. Gastrointest Endosc 2009; 69: 341; discussio 341.
 
[5]  Okuma Tofigh AM, Hashemi M, Honar BN, Solhjoo F. Rare presentation of pancreatic schwannoma: a case report. J Med Case Reports 2008; 2: 268.
 
[6]  Yu RS, Sun JZ. Pancreatic schwannoma: CT findings. Abdom Imaging 2006; 31: 103-105.
 
[7]  Novellas S, Chevallier P, Saint Paul MC, Gugenheim J, Bruneton JN. MRI features of a pancreatic schwannoma. Clin Imaging 2005; 29: 434-436.
 
[8]  Li S, Ai SZ, Owens C, Kulesza P. Intrapancreatic schwannoma diagnosed by endoscopic ultrasound-guided fine-needle aspiration cytology. Diagn Cytopathol 2009; 37: 132-135.
 
[9]  Tafe LJ, Suriawinata AA. Cystic pancreatic schwannoma in a 46-year-old man. Ann Diagn Pathol 2008; 12: 296-300.
 
[10]  Eggermont A, Vuzevski V, Huisman M, De Jong K, Jeekel J. Solitary malignant schwannoma of the pancreas: report of a case and ultrastructural examination. J Surg Oncol 1987; 36: 21-25.
 
[11]  Weiss SW, Langloss JM, Enzinger FM. Value of S-100 protein in the diagnosis of soft tissue tumors with particular reference to benign and malignant Schwann cell tumors. Lab Invest 1983; 49: 299-308.
 
[12]  Paranjape C, Johnson SR, Khwaja K, Goldman H, Kruskal JB, Hanto DW. Clinical characteristics, treatment, and out- come of pancreatic Schwannomas. J Gastrointest Surg 2004; 8: 706-712.