Schwannoma in the hepatoduodenal ligament: A case report and literature review

• Published in: World journal of gastroenterology : WJG 2016-12, Vol.22 (46), p.10260-10266
• Main Authors: Xu, Shao-Yan, Sun, Ke, Xie, Hai-Yang, Zhou, Lin, Zheng, Shu-Sen, Wang, Wei-Lin
• Format: Article
• Language: English
• Subjects: Adult; Case Report; Cholangiopancreatography, Endoscopic Retrograde; Cholangiopancreatography, Magnetic Resonance; Cholecystectomy; Cholestasis - complications; Cholestasis - therapy; Common Bile Duct; Constriction, Pathologic - complications; Constriction, Pathologic - therapy; Cystic Duct - surgery; Humans; Jaundice - etiology; Ligaments; Male; Neurilemmoma - diagnostic imaging; Neurilemmoma - metabolism; Neurilemmoma - surgery; Omentum - surgery; Peritoneal Neoplasms - diagnostic imaging; Peritoneal Neoplasms - metabolism; Peritoneal Neoplasms - surgery; Postoperative Complications - therapy; S100 Proteins - metabolism; Stents; Tomography, X-Ray Computed
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i46.10260

Schwannomas are mesenchymal neoplasms with low malignant potential that arise from Schwann cells. They can occur almost anywhere, although the most common locations are the head, neck and extremities. Primary benign schwannoma of the hepatoduodenal ligament is rare. To date, only three cases have been reported in the English literature. In the present study, we report a case of hepatoduodenal ligament schwannoma in a 43-year-old male, who was admitted to our hospital because of a abdominal mass found by physical examination. It was hard to determine the definitive location and diagnosis of the mass using ultrasound, computed tomography and magnetic resonance cholangiopancreatography. During laparotomy, the mass was found in the hepatoduodenal ligament and close to the cholecystic duct, so we resected the gallbladder and cholecystic duct along with the mass. The gross specimen revealed an 8.5 cm × 5.5 cm × 3.0 cm localized tumor. Microscopic examination showed that the tumor was mainly composed of spindle-shaped cells. Immunohistochemical staining showed a strong positive S-100 protein reaction. Finally, the lesion was diagnosed as a benign schwannoma in the hepatoduodenal ligament. However, one month later, the patient was readmitted to our hospital because of skin and sclera jaundice caused by common bile duct stenosis without common bile duct stone or tumor. The patient recovered well after implantation of a common bile duct stent under endoscopic retrograde cholangiopancreatography. He was followed up for a period of 17 mo, during which he was well with no complications.