Abstract
A 79-year-old man was referred to our hospital for close examinations of macrohematuria. Computed tomography (CT) revealed incidentally a solid and cystic tumor in the head of the pancreas with partial enhancement in the solid component, in addition to a renal tumor. Ultrasonography showed a 5-cm solid and cystic mass. Magnetic resonance imaging (MRI) revealed a hypointens mass on T1-weighted images and a heterogenous hyperintens mass on T2-weighted images. The lesion showed high 18F-fluorodeoxyglucose (FDG) uptake. He underwent a subtotal stomach-preserving pancreatoduodenectomy under a tentative diagnosis of malignant cystic neoplasm of the pancreas. The cut surface of the resected specimen showed a well-demarcated solid and cystic tumor within the pancreas parenchyma. Histopathological examination of the tumor revealed proliferation of the spindle cells showing interlacing and palisading patterns. Immunohistochemically, these spindle cells were positive for S-100 protein. As a result, the tumor was diagnosed as a pancreatic schwannoma. Although it is a rare type of lesion, pancreatic schwannoma should be considered in the differentiated diagnosis of cystic neoplasm of the pancreas.
