A Rare Case of Cystic Schwannoma of the Portal Triad

Schwannomas can occur anywhere throughout the body and have often been mistaken for more-sinister lesions, especially when found in relation to the pancreas. Clinical symptoms range from none to vague abdominal pain, back pain, anorexia, weight loss, vomiting, jaundice, and episodes of cholangitis and gastrointestinal bleeding. Preoperative diagnosis is difficult, and endoscopic ultrasound with fine-needle aspiration is often limited in specificity. Given the low statistical likelihood of schwannomas, therapy is usually targeted at the possibility of pancreatic cystadenoma/cystadenocarcinoma. Simple enucleation is usually the preferred treatment, and diagnosis can be established at the time of operation by frozen section. Schwannomas can be malignant, but preoperative imaging and pathology can help establish the benign nature of most specimens. Patients typically do well with resolution of symptoms. Here we present the case of a patient with abdominal pain and a peripancreatic mass observed with computed tomography, who was found to have a cystic schwannoma extending from the portal triad. The mass was removed and the patient was discharged without complications.