ABSTRACT BACKGROUND: The extrapancreatic nerve plexus may give rise to schwannomas. The aim of this study was to define the clinicopathologic features of peripancreatic schwannoma and to allow improved diagnosis and treatment for this condition. METHODS: A retrospective analysis was performed on 17 patients with pathologically proven peripancreatic schwannoma (defined as schwannoma in anatomic proximity to the pancreas) treated at our hospital between 1995 and 2011. RESULTS: The patient group included 9 men and 8 women between the ages of 26 and 67 years. The tumor size ranged from 2.5 to 13 cm. Tumor locations were the pancreatic head plexus in 5 patients, the superior mesenteric plexus in 3, the pancreatic head and superior mesenteric plexus in 2, the celiac plexus in 4, and the splenic plexus in 3. The main symptoms were vague abdominal pain (n = 5; 29.4%) and abdominal mass (n = 2; 11.8%). A correct preoperative diagnosis was made in 12 patients by either computed tomography (CT) or magnetic resonance imaging (MRI). Sixteen patients (94.1%) underwent total resection and 1 patient (5.9%) underwent subtotal resection. Three patients underwent concomitant pancreatectomy. No recurrences were noted in the 16 patients who underwent total tumor resection. CONCLUSION: Most peripancreatic schwannomas are benign. Peripancreatic schwannoma may often be accurately diagnosed before surgery by its typical location and CT or MRI findings. Total resection is important for treatment, and no recurrences are seen when resection is complete. Prognosis after total resection is extremely good.
Article: Retroperitoneal neurilemoma.[Show abstract] [Hide abstract]
ABSTRACT: Large retroperitoneal neurilemomas are rare. Five such cases are reported in four men and one woman varying in age from twenty-seven to seventy-five years. The tumor was found incidentally during examinations for other conditions in three cases. The other cases presented with abdominal pain, discomfort and increased abdominal girth. The tumors were all attached to the anterior surface of the sacrum. They varied in size from 12 cm in diameter to one containing more than 81 of fluid.The proper treatment is dependent on recognition of the tumor. Laparotomy with adequate biopsy is the preferred method. Due to the thickness of the capsule, a deep incision is necessary to obtain representative tissue. Needle biopsy may be complicated by the development of an infection within the tumor, hemorrhage, and inadequate tissue for diagnosis. The larger the tumor, the greater is the amount of degeneration and cyst formation.Neurilemomas are rarely, if ever, malignant. They may recur if inadequately excised. They displace the bowel, ureters, and major vessels. The capsule is usually thick and very vascular. Angiographic studies are of value in determining location and operability. These tumors may be enucleated from the capsule using packs for control of the extensive venous bleeding. Radiation therapy, although not effective in treatment of the tumor, will result in a decrease in the blood supply. If a tumor is located in regions of difficult access and is very vascular, resection should be considered, based on the presence or absence of symptoms and the patient's age and general condition. After determining the diagnosis by biopsy and frozen section, the tumor may be left alone with less danger to the patient's life.The American Journal of Surgery 08/1977; 134(1):140-5. DOI:10.1016/0002-9610(77)90297-5 · 2.41 Impact Factor
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ABSTRACT: Retroperitoneal schwannoma is a rare tumor that originates in the neural sheath and accounts for only a small percentage of retroperitoneal tumors. Presentation is typically varied and non-specific ranging from abdominal pain, abdominal mass or an incidental finding and the diagnosis is quite often fortuitous being confirmed by anatomopathological study afterwards. We report 3 cases of benign retroperitoneal pelvic schwannoma with varied presentations. Main symptoms were abdominal and pelvic pain whereas a patient with left parailiac mass had urinary incontinence and left lower extremity pain. Surgical exploration and complete excision of tumors were successful. The histological diagnosis of the tumors was reported as benign schwannoma. All patients are doing well and had no symptoms of motor or sensory disturbances after surgery with a mean follow up of 18 mounts.The Tohoku Journal of Experimental Medicine 07/2003; 200(2):93-7. DOI:10.1620/tjem.200.93 · 1.28 Impact Factor
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ABSTRACT: A clinicopathological study of 44 ductal carcinomas of the head of the pancreas revealed 39 with retroperitoneal invasion, of which 27 showed extrapancreatic plexus involvements. The second portion of the plexus pancreaticus capitalis was the most frequent site of invasion. A statistically significant correlation was found between neural invasion in the pancreatic tissue and plexus invasion, but no clear correlation was found between plexus invasion and lymphatic invasion or tumor size. Even small-sized tumors (t1) showed plexus invasion. The cases with plexus invasion had a statistically higher incidence of lymph-node involvement around the superior mesenteric artery than those without plexus invasion. These results indicate that complete dissection of extrapancreatic plexus around the superior mesenteric artery, including lymph nodes and soft tissue, could prolong the survival of patients with ductal carcinoma of the pancreas, even in cases of small-sized carcinomas.International journal of pancreatology: official journal of the International Association of Pancreatology 11/1991; 10(2):105-11. DOI:10.1007/BF02924113