L M Toh1, S K Wong. 1. Department of Diagnostic Imaging, Singapore General Hospital, Singapore. lukehwtoh@yahoo.com
Abstract
INTRODUCTION: Benign cystic schwannoma of the lesser sac is an extremely rare condition and only 3 reports were found in our review of the English literature. CLINICAL PICTURE: We describe a 58-year-old man with a large (5.2 x 6.7 x 7.6 cm) epigastric mass with solid and cystic components detected on sonography and computed tomography. Close association with the pancreas, stomach and liver led to a mistaken diagnosis of pancreatic cystadenoma/cystadenocarcinoma. TREATMENT AND OUTCOME: The mass was surgically resected and our patient has been well since. CONCLUSION: This case draws the reader's attention to a rare condition that may mimic other sinister lesions, and highlights the pitfalls of diagnosis. Depending on the size and extent of the lesion, imaging may assist in characterisation of a schwannoma of the lesser sac. Surgical resection would still be the end point of management, especially when mass effect causes debilitating symptoms. Surgery is usually associated with good outcome, and tumour recurrence is unusual, provided adequate margins are resected.
INTRODUCTION:Benign cystic schwannoma of the lesser sac is an extremely rare condition and only 3 reports were found in our review of the English literature. CLINICAL PICTURE: We describe a 58-year-old man with a large (5.2 x 6.7 x 7.6 cm) epigastric mass with solid and cystic components detected on sonography and computed tomography. Close association with the pancreas, stomach and liver led to a mistaken diagnosis of pancreatic cystadenoma/cystadenocarcinoma. TREATMENT AND OUTCOME: The mass was surgically resected and our patient has been well since. CONCLUSION: This case draws the reader's attention to a rare condition that may mimic other sinister lesions, and highlights the pitfalls of diagnosis. Depending on the size and extent of the lesion, imaging may assist in characterisation of a schwannoma of the lesser sac. Surgical resection would still be the end point of management, especially when mass effect causes debilitating symptoms. Surgery is usually associated with good outcome, and tumour recurrence is unusual, provided adequate margins are resected.
Authors: Brian K P Goh; Pierce K H Chow; Sittampalam Kesavan; Wai-Ming Yap; Hock-Soo Ong; In-Chin Song; Kong-Weng Eu; Wai-Keong Wong Journal: J Gastrointest Surg Date: 2007-12-12 Impact factor: 3.452