Abstract
Vascular neoplasms of the pancreas are extremely rare and usually manifest as symptomatic, cystic lesions. This study presents a case that includes the clinicopathologic information used to discriminate pancreatic hemangioma from other types of cystic lesion of the pancreas. A 40-year-old female visited hospital with a chief complaint of abdominal pain. The serum CEA and CA19-9 levels of the patient were within the normal limits. An abdominal computed tomography scan and magnetic resonance imaging showed a 100-mm mass lesion in the body and tail of the pancreas, and the tumor extended toward the retroperitoneum and surrounded the splenic vein. The lesion was subsequently resected. Macroscopically, it was a multiloculated cyst with intracystic hemorrhage. Microscopically, the lesion was composed of numerous, heterogeneous cysts lined by a flattened single layer of cells without significant atypia. Notably, numerous neoplastic vessels extended into the interlobular septa of the pancreas and surrounded the main pancreatic duct. Immunohistochemical analysis showed that the lining cells expressed CD31 and CD34. The lesion was diagnosed as adult pancreatic hemangioma. Surgical treatment may be required when a direct contact between the lesion and the pancreatic tissue is demonstrated using imaging.
Highlights
Vascular neoplasms usually occur in the visceral organs including the liver, spleen and gastrointestinal tract and occsionaly in the pancreas
The present study reports the case of an adult patient with a giant pancreatic hemangioma without recurrence 6 years following curative surgery
Pancreatic vascular neoplasm is an uncommon type of primary cystic neoplasm [1]
Summary
Vascular neoplasms usually occur in the visceral organs including the liver, spleen and gastrointestinal tract and occsionaly in the pancreas. Adult pancreatic hemangiomas often manifest as large cystic lesions in middle-age females and in many cases the patients exhibit abdominal pain but no evidence of malignancy [2,3], accurate diagnosis is essential for their. The tumor extended into the retroperitoneum and surrounded the splenic vein (Fig. 1A). The case was reviewed in a Multidisciplinary Surgery Conference at St. Mary's Hospital, and was diagnosed as a cystic neoplasm arising in the retroperitoneum or pancreas. The cysts extended into the interlobular septa of the pancreas and surrounded the main pancreatic duct (Fig. 3B). The lesion was diagnosed as adult pancreatic hemangioma. Following full explanation of the findings, the patient accepted the proposed surgical removal. Surgical exploration revealed an 85‐mm mass in the pancreatic body and tail that was inseparable from the pancreas.
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