Abstract
A 44-year-old woman detected having a tumor at the porta hepatis by an abdominal ultrasonography at a medical checkup was seen at our hospital. An abdominal CT scan showed a distinctly outlined smooth tumor with the longer diameter of 82 mm in the hepatoduodenal ligament. The tumor compressed the common hepatic artery anteriorly, the portal vein posteriorly, the right hepatic artery and the bile duct toward the right and the left hepatic artery toward the left. The tail side closely adhered to the pancreatic head. The inner part showed low density and the margin was associated with faint high density area and minute calcifications. Enhancement revealed gradually enhancing deep stain at the margin, but the enhancement effect was scarce in the center part. We speculated that the tumor might arise in the hepatoduodenal ligament and schwannoma might be most likely, and performed removal of the tumor. The section mostly showed yellow with slightly transparent property with concomitant dark red parts. Histopathology revealed proliferation of spindle-shaped cells at the margin of the tumor at where there were areas showing bundle arrangement and edematous areas concomitantly. The spindle-shaped cells were positive for S-100, and schwannoma was diagnosed.
As we preoperatively speculated that the tumor might be a benign schwannoma, the tumor alone could be removed by conserving the hepatic arteries, portal vein, and bile duct which had closely adhered to the tumor.
