Benign schwannoma in the pancreatic head is very rare, with only 11 patients being reported in the English literature from a Medline search. Furthermore, only 1 of them was treated by simple enucleation. Herein, we present another enucleation case: a 71-year-old male patient with a 1.5 x 1.2-cm low-density mass, mimicking a cystic lesion located at the head of pancreas, which was detected by computed tomography. This tumor failed to be discovered by abdominal ultrasound. At laparotomy, a solid mass 1 cm in diameter was identified; it was the smallest one in the pancreatic head according to the 11 previous reported cases. No complications were found after the operation. At 10-month follow-up, the patient remains asymptomatic and has no signs of recurrence. The data of the 12 patients indicated that simple minimal invasive enucleation for small benign schwannoma in the pancreatic head was feasible and safe; early detection and early treatment of the tumor were helpful in increasing the ratio of enucleation and avoiding a very invasive Whipple operation.

The extended Appleby's procedure without blood flow of PHA might be feasible and offered a new approach to resection of pancreatic cancer involving CA and/or CHA; the involvement of pancreatic head might not be the contraindication for Appleby's operation.