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Journal of Pathology and Disease Biology | Volume 2
September 06-07, 2018 | Edinburgh, Scotland
Pathology and Surgical Pathology
International Conference on
Intra-pancreatic schwannoma masquerading as a cystic neoplasm of pancreas: A rare case report
Sai Kumar Maley, Nam Dev Vadla, Vikas Reddy Byreddy, Jai Kishan Rao Lomte
and
Chanakya Charan Tirumala
Osmania Medical College, India
I
ntra-pancreatic schwannomas are rare neoplasms,
presenting with vague symptoms of abdominal discomfort
or pain or sometimes asymptomatic. Preoperative imaging
in two-thirds of cases appears as cystic neoplasm’s, implying
a whipple resection. If a definitive pre-operative diagnosis of
schwannoma is made confidently, that will spare extensive
surgery and associated morbidity. According to the recent
literature less than 50 cases are reported in English literature
in past 30 years. Here we report a 26 years old female
presented with complaints of lump and pain in the abdomen
for one year. On local examination 8X7cm hard immobile
lump in the epigastrium, extending into right hypochondrium
& umbilical regions. Rest of the abdominal examination is
unremarkable. Patient was further evaluated by doing routine
blood, biochemical and imaging studies. Initial imaging study
by ultrasonography revealed lobulated well-defined mass in
the head &uncinate process. Contrast enhanced computed
tomography (CECT) revealed 8.3 X 7.4 cm heterogenous, well
defined lobulated minimal progressive enhancing hypodense
lesion noted involving head and neck of pancreas causing
compression and dilation of the pancreatic duct (PD-4.4mm).
Fine needle aspiration done during ultrasound showed a
gelatinous aspirate. Cytosmear of the aspirate revealed only
benign columnar epithelial cells. Provisional diagnosis of Solid
pseudopapillary tumour of pancreas was made and case was
proposed for surgical management by whipple pancreatico-
duodenectomy procedure. Grossly the tumour was identified
in the head of pancreas measuring8X7cm and the surface
appeared lobulated. Histopathological examination revealed
an encapsulated, well circumscribed tumour with adjacent
compressed pancreatic tissue. Tumour tissue is composed of
spindle cells with cellular palisading into Antoni A and Antoni
B areas. Immunohistochemistry was performed with S-100
diffuse positivity and negative cytokeratin, CD117 and AE1/AE3,
confirming the tumour mass as a benign nerve sheath tumour-
Schwannoma.
Speaker Biography
Sai Kumar Maley has completed his residency training in pathology and senior
residency from Osmania Medical College. He is interested in research on pulmonary
malignancies and his post-doctoral dissertation work was centered on the
immunocytochemical diagnosis of pulmonary malignancies in low resource setup’s
and his work highlighted an effective and economical usage of immunohistochemical
markers and worked on the preanalytical variables influence on the outcomes.
e:
sai.maley@gmail.com