Defficult-to-diagnose Cavernous Hemanginoma of the Retroperitoneum Developing Around the Pancreas—A Case Report—

Abstract

A-72-year-old man was referred to our hospital because of incidental detection of a cystic lesion around the pancreas on abdominal CT. As we could not make a precise qualitative diagnosis, the patient was kept under observation with regular radiologic examination. The tumor was found to grow gradually in size, therefore, under the suspected diagnosis of a pancreatic cystic neoplasm, we performed spleen-preserving distal pancreatectomy. A multilocular cystic tumor was found, which was thickly encapsulated. The pancreas adjacent to the tumor showed inflammatory changes. On histopathology, the tumor was diagnosed as a cavernous hemangioma of the retroperitoneum, with no histological continuity between the tumor and the pancreas. The patient was discharged 16 days after surgery without any complication. Retroperitoneal cavernous hemangioma typically exhibits hypovascular staining, however, it is often difficult to diagnose because of its very low incidence. In addition, it was even more difficult to diagnose in our case, because the tumor developed adjacent to pancreas. Cavernous hemangioma should be considered in the differential diagnosis of hypovascular cystic tumors, because in most previous cases, surgery has been performed without preoperative diagnosis.