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A case of pancreatic schwannoma - The features in imaging studies compared with its pathological findings: Report of a case

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Abstract

Pancreatic schwannoma is a very rare tumor that tends to be confused with other pancreatic tumors preoperatively. We report a case of schwannoma of the pancreatic head. A 40-year-old woman was admitted to our hospital for treatment of a pancreatic tumor which was found by medical checkup. It was a well-defined solid tumor exhibiting heterogeneous enhancement with some necrotic foci on contrast-enhanced computed tomography (CT) and on magnetic resonance imaging (MRI). Angiography and CT during arteriography revealed the main feeding arteries of the tumor to be the posterior and anterior superior pancreaticoduodenal arteries. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed accumulation of FDG in the tumor with a maximum standardized uptake value of 3.6. We diagnosed a solid pseudopapillary neoplasm or a pancreatic neuroendocrine tumor preoperatively and performed pylorus-preserving pancreaticoduodenectomy. The tumor had well a well-defined capsule and was composed of a large solid portion containing spindle cells and a smaller hemorrhagic portion containing hypocellular stroma, and diagnosed as pancreatic schwannoma by immunohistochemistry. In this case, CT during arteriography was useful in determining the origin of the tumor. MRI reflected the pathological features of the tumor. The most important finding was that FDG-PET showed abnormal accumulation of FDG in the benign pancreatic schwannoma.

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Disclosures

Conflict of Interest

Yoshinao Ohbatake, Isamu Makino, Hirohisa Kitagawa, Shinichi Nakanuma, Hironori Hayashi, Hisatoshi Nakagawara, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Takashi Fujimura and Tetsuo Ohta declare that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan

    Yoshinao Ohbatake, Isamu Makino, Hirohisa Kitagawa, Shinichi Nakanuma, Hironori Hayashi, Hisatoshi Nakagawara, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Takashi Fujimura & Tetsuo Ohta

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  1. Yoshinao Ohbatake
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  2. Isamu Makino
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  3. Hirohisa Kitagawa
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  4. Shinichi Nakanuma
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  5. Hironori Hayashi
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  6. Hisatoshi Nakagawara
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  7. Tomoharu Miyashita
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  8. Hidehiro Tajima
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  9. Hiroyuki Takamura
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  10. Itasu Ninomiya
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  11. Sachio Fushida
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  12. Takashi Fujimura
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  13. Tetsuo Ohta
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Correspondence to Yoshinao Ohbatake.

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Ohbatake, Y., Makino, I., Kitagawa, H. et al. A case of pancreatic schwannoma - The features in imaging studies compared with its pathological findings: Report of a case. Clin J Gastroenterol 7, 265–270 (2014). https://doi.org/10.1007/s12328-014-0480-8

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  • DOI: https://doi.org/10.1007/s12328-014-0480-8

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