Ganamani Akhil C, Palanichamy Suresh K, Subramaniam Sankar
Surgical Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2025 Jun 13;17(6):e85916. doi: 10.7759/cureus.85916. eCollection 2025 Jun.
Retroperitoneal schwannomas, as such, are a rare entity, and those located near the pancreas and duodenum may emulate pancreatic tumors on imaging, making a diagnosis, surgical planning, and patient counselling challenging. Their low incidence and nonspecific clinical presentation often hinder preoperative identification. This case series presents three female patients who presented with either mild epigastric discomfort or incidental findings during routine health evaluations. Contrast-enhanced CT scans revealed well-circumscribed, heterogeneous cystic lesions in the retroperitoneal space adjacent to the pancreas and duodenum. Each patient underwent a complete surgical excision of the tumor. Histopathological examination confirmed schwannomas, exhibiting typical Antoni A and Antoni B areas, as well as Verocay bodies. S-100 protein positivity was noted on immunohistochemical staining, supporting the diagnosis of a benign nerve sheath tumor. All patients experienced a smooth recovery after surgery, and no recurrences were noted during the follow-up period lasting for a year. These cases emphasise three different locations of retroperitoneal schwannomas: juxtapancreatic, retroduodenal, and posterior to the head of the pancreas, between the second part of the duodenum and the right kidney. A definitive diagnosis relies on histopathological and immunohistochemical findings. Surgical excision remains the preferred treatment and is associated with excellent outcomes.
腹膜后神经鞘瘤本身是一种罕见的疾病,位于胰腺和十二指肠附近的神经鞘瘤在影像学上可能类似胰腺肿瘤,这给诊断、手术规划和患者咨询带来了挑战。其低发病率和非特异性临床表现常常妨碍术前识别。本病例系列介绍了三名女性患者,她们要么表现为上腹部轻度不适,要么在常规健康评估中偶然发现。增强CT扫描显示,在胰腺和十二指肠附近的腹膜后间隙有边界清晰的异质性囊性病变。每位患者均接受了肿瘤的完整手术切除。组织病理学检查证实为神经鞘瘤,表现出典型的Antoni A区和Antoni B区以及Verocay小体。免疫组织化学染色显示S-100蛋白呈阳性,支持良性神经鞘瘤的诊断。所有患者术后恢复顺利,在为期一年的随访期间未发现复发。这些病例强调了腹膜后神经鞘瘤的三个不同位置:胰旁、十二指肠后以及胰头后方,在十二指肠第二部和右肾之间。明确诊断依赖于组织病理学和免疫组织化学检查结果。手术切除仍然是首选的治疗方法,且预后良好。