Successfully enucleation of a rare pancreatic schwannoma: A case report

Abstract

INTRODUCTION AND IMPORTANCE: Pancreatic schwannoma (PS) is an extremely rare benign tumor also known as neurilemoma or neuroma. The majority of PS develop cystic lesions, and its preoperative diagnosis is challenging due to its tendency to mimic other lesions of the pancreas. Herein, we reported a case of body PS incidentally discovered in an 81-year-old male, which was successfully treated through enucleation. CASE PRESENTATION: We report the case of a 81-year-old man. Who presented with a well-defined polycystic-tumor of about 2cm at the pancreatic body, overdrawn by a computed tomography scan, incidentally discovered. The patient underwent a laparotomy, and we performed an enucleation of the tumor successfully. Histopathological examination revealed spindle-shaped cells. Immunohistochemically studies showed S100-protein expression, confirmed a body pancreatic schwannoma. The postoperative course was uneventful. CLINICAL DISCUSSION: Schwannomas are rare mesenchymal-tumors, with PS accounting for only 1 % of cases. They are often difficult to diagnose as they mimic other pancreatic tumors. Imaging techniques like CT, MRI, and EUS-FNA aid in detection, but definitive diagnosis requires histological and immunohistochemical analysis. Treatment is typically enucleation for benign tumors, but larger or malignant tumors may need more extensive resections. Due to diagnostic challenges, aggressive surgeries are common. Prognosis is generally favorable, but regular follow-ups are recommended to monitor for recurrence. CONCLUSION: Although pancreatic schwannoma is rare, it should be included in the list of differential diagnoses of pancreatic masses, both solid and cystic. Both enucleation and radical surgical resections have revealed great therapeutic efficiency with a well prognosis without recurrences.