Melanotic Schwannoma of the Pancreas: Report of a Case

Akiyoshi, Takashi; Ueda, Y.; Yanai, Kohsuke; Yamaguchi, Hiroshi; Kawamoto, Masahiko; Toyoda, Kazutaka; Hayashi, Tohru; Ohuchida, Jiro

doi:10.1007/s00595-004-2744-2

Cited by 34 publications

(24 citation statements)

References 13 publications

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“…(See Table 1. [31][32][33][34][35][36][37][38][39][40][41] In conclusion, we present a case of an 8-cm pancreatic schwannoma characterized by cystic degeneration, which was asymptomatic and was diagnosed incidentally while an examination was performed for an ovarian teratoma. Although pancreatic schwannoma is a rare benign disease, it should be included in the list of differential diagnoses of pancreatic mass with cystic changes.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Schwannoma: Literature Review

Gupta

Subhas

Mittal

et al. 2009

Journal of Surgical Education

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Section: Discussionmentioning

confidence: 99%

Pancreatic Schwannoma: Literature Review

Gupta

Subhas

Mittal

et al. 2009

Journal of Surgical Education

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“…[2][3][4][5][6] In 1990, Carney 7 noted the very frequent (B50%) association of MS with other stigmata of Carney complex (skin pigmentary abnormalities, myxomas, endocrine tumors, or endocrine overactivity). Since then, <200 cases, most often occurring in the paraspinal nerve roots and gastrointestinal tract, have been described, chiefly in the form of case reports or small series.…”

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confidence: 99%

Malignant Melanotic Schwannian Tumor

Torres‐Mora

Dry

et al. 2014

American Journal of Surgical Pathology

180

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Melanotic schwannomas (MSs), variably associated with the Carney complex, are rare tumors that usually involve spinal nerve roots but may occur in other locations. Clinicopathologic evaluation poorly predicts the behavior of MS. Fewer than 200 cases have been reported. We report a series of 40 well-characterized MSs, one of the largest series to date. The tumors were comprehensively evaluated, and clinical follow-up was obtained. Immunohistochemistry for S100 protein, Melan-A, HMB45, tyrosinase, glial fibrillary acidic protein (GFAP), EMA, SMARCB1, Ki-67 antigen, ASMTL, and the Carney complex-associated PRKAR1A gene product was performed using commercially available antibodies and the Ventana Ultraview detection system. Gene microarray study was conducted on formalin-fixed, paraffin-embedded blocks from 10 MSs and the results compared with previous data from melanoma and schwannoma. Differentially expressed genes were selected at >3-fold and P<0.001. The Fisher exact test was used for statistical analysis. The tumors occurred in 18 male and 22 female patients (mean age 41 y; range, 11 to 84 y) and involved the paravertebral nerve roots (N=31), mediastinum (N=3), sacrum, cauda equina, para-aortic region, fifth cranial nerve, buttock, and cerebellum (N=1 each). Two patients had known Carney complex, and 1 patient also had a cutaneous myxoma, suggestive of Carney complex. The tumors expressed S100 protein (21/25, 84%), Melan-A (23/25, 92%), HMB45 (25/25, 100%), tyrosinase (25/25, 100%), GFAP (0/24, 0%), EMA (0/9, 0%), SMARCB1 (retained in 25/25, 100%), and ASMTL (5/19, 26%); PRKAR1A expression was lost in 7/20 cases (35%). Ki-67-labeling index was <5% in 23/25 cases (92%) and 5% to 10% in 2/25 cases (8%). Gene expression profiling showed significant differences between MS, melanoma, and conventional schwannoma. Clinical follow-up (26/40, 65%; mean 55 mo; range, 1 to 300 mo) showed local recurrences in 9/26 (35%) and metastases in 11/26 (44%) patients. Fourteen patients were alive without disease, 5 were alive with disease, and 7 had died of disease. Only a mitotic rate >2/10 HPF correlated with metastases (P=0.008). The clinicopathologic features of tumors with and without psammoma bodies were identical. We conclude that MSs are distinctive malignant tumors, rather than benign neoplasms with occasionally unpredictable behavior, and propose their reclassification as "malignant melanotic schwannian tumors." Loss of PRKAR1A expression suggests a link to Carney complex, even when this history is absent.

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“…The most common reasons for nonenucleation were that it was difficult to separate tumors from the peritumor vessels or tissues, including the portal vein, superior mesenteric vessels, or normal pancreas, and the possibility of malignancy was not excluded. 1,[3][4][5][6]9,12,17 In conclusion, abdominal pain was not dependent on the size of the BSPH and was likely 1 of the earlier signs of the BSPHs. Abdominal US was not enough to detect the small schwannomas in the head of the pancreas.…”

Section: Discussionmentioning

confidence: 92%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] One-half of the 22 patients had tumors located in the pancreatic head. Several reports showed that simple enucleations of benign tumors in the pancreatic head were feasible, safe, and recommended if possible.…”

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confidence: 99%

Pancreatic Benign Schwannoma Treated by Simple Enucleation: Case Report and Review of Literature

Yan²,

Chen³

et al. 2005

Pancreas

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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.

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Melanotic Schwannoma of the Pancreas: Report of a Case

Cited by 34 publications

References 13 publications

Pancreatic Schwannoma: Literature Review

Pancreatic Schwannoma: Literature Review

Malignant Melanotic Schwannian Tumor

Pancreatic Benign Schwannoma Treated by Simple Enucleation: Case Report and Review of Literature

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