Abstract
Solitary malignant schwannoma of the duodenum is extremely rare. In fact, only two previous reports on successful radical resection of a solitary malignant schwannoma of the duodenum have been documented in the Japanese literature, and there are none in the English literature. We report herein the unique case of a 64-year-old man with a malignant schwannoma of the duodenum in whom both the primary lesion and a metachronous metastatic lesion were successfully resected. The patient initially underwent a Whipple procedure for a hypervascular tumor in the head of the pancreas. The tumor was composed of palisading spindle cells and scattered S-100 protein-positive cells with prominent mitotic figures, and was diagnosed as a malignant schwannoma of the duodenum. A second admission, 3 years later, revealed the presence of a solitary hypervascular hepatic tumor in the anterior segment of the right lobe of the liver. The hepatic tumor was resected and confirmed, microscopically and immunohistochemically, as a metastasis from the malignant schwannoma of the duodenum. The patient is alive 3 years and 6 months after his initial operation. To our knowledge no other report on the successful radical resection of both primary and metastatic lesions has been documented. This case report therefore highlights the importance of performing follow-up examinations focusing on the liver, and encourages an aggressive surgical attitude for the treatment of this unusual disease.
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Trojanowski JQ, Kleinman GM, Proppe KH (1980) Malignant tumors of nerve sheath origin. Cancer 46:1202–1212
Temelkor S (1971) A case of neurinoma of the pancreas with malignant degeneration. Khirurgia (Sofia) 24:527–528
Moller Pedersen V, Hede A, Graem N (1982) A solitary malignant schwannoma mimicking a pancreatic pseudocyst. Acta Chir Scand 148:697–698
Wimmer VB, Gospos C, Ruf G, Wagner R (1982) Neurilemmom des Pankreas. Fortschr Rontgenstr 137:731–734
Eggermont A, Vuzevski V, Huisman M, Jong JD, Jeekel J (1987) Solitary malignant schwannoma of the pancreas: Report of a case and ultrastructural examination. J Surg Oncol 36:21–25
Cedermark J (1949) Neurinoma in the gastro-intestinal tract. Acta Chir Scand 97:473–484
Elliot A, Hansson CJ (1951) Neurosarcoma duodeni. Acta Radiol 35:407–412
Nilsson B, Jonsson I (1957) Malignant neurinoma of the duodenum. Report of one case and review of the literature. Acta Chir Scand 113:357–363
Itou S, Nakamura T, Kumagai M, Watanabe T, Masaoka K, Kumai M, Kamitou Y, Tsuruoka, Y, Koide K, Shimizu N, Katou A (1987) A case of malignant schwannoma of the duodenum. (in Japanese with English abstract). Shiyokaki Naishikyo no Shimpo 31:358–361
Koyou T, Matsumura A, Matsuda M, Numano F, Kamisaka K, Maesawa H, Shimoshige K, Nakamura H, Goseki Y (1989) A case report of malignant schwannoma of the duodenum (in Japanese). Gastroenterol Endoscopy 31:1842–1847
Eguchi S, Motojima K, Hashimoto S, Kajiwara Y, Obara N, Tsunoda T, Kanematsu T (1994) A case report of malignant schwannoma of the duodenum (in Japanese with English abstract). Jpn J Gastroenterol Surg 27:112–116
Sordillo PP, Helson L, Hadjdu SI, Magill GB, Kostoff C, Golbeg RB, Beatie EJ (1981) Malignant schwannoma—Clinical characteristics, survival, and response to therapy. Cancer 47:2503–2509
Matsunou H, Shimoda T, Kakimoto S, Yamashita H, Ishikawa E, Mukai M (1985) Histopathologic and immunohistochemical study of malignant tumors of peripheral nerve sheath (malignant schwannoma). Cancer 56:2269–2279
Nakajima T, Watanabe S, Sato Y, Kameya T, Hirota T, Shimosato Y (1982) An immunoperoxidase study of S-100 protein distribution in normal and neoplastic tissues. Am J Surg Pathol 6:715–727
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Tanaka, N., Nobori, M., Furuya, T. et al. Solitary malignant schwannoma of the duodenum with metastasis to the liver: Report of a case. Surg Today 27, 1173–1176 (1997). https://doi.org/10.1007/BF02385689
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DOI: https://doi.org/10.1007/BF02385689