SCHWANNOMA CUỐNG GAN, MẠC NỐI NHỎ: BÁO CÁO LOẠT CA LÂM SÀNG HIẾM GẶP VÀ ĐIỂM LẠI Y VĂN

Abstract

Aim of study

Retrospective study aims at 1. Evaluation of the clinical and paraclinical characteristics of Schwannoma of the hepatoduodenal ligament and Lesser Sac. 2. Surgical result and review of literature.

Results

There were 2 patients.

Case one: 29 year-old male with history of spinal neurinome surgery. Symptoms: Epigastric pain, weight loss, loss of appetite. Physical examination: Mass palpable epigastric.

Routine blood tests were normal. Ctscan revealeda well-defined 7-9 cm tumor, mixed solid-cystic lesion, heterogeneous enhancement, located posterior to hepatoduodenal ligament, posterior to  pancreatic head and D1- D2 duodenum.

Surgical procedure: Tumor located posterior to posterior to  pancreatic head and D2 duodenum. Juxta  hepatoduodenal ligament, abuting to lesser sac, anterior to inferior vena cava. Surgical excision tumor with R0 resection. Histopathologic result showed schwannoma.

Case two: 46 year-old female patient. Symptoms: Epigastric pain, loss of appetite. There was no palpable tumor on physical examination. Ctscan showed well-defined tumor juxta gastric cardia measuring 21-23 mm. Gastroduodenal copy revealed gastroduodenal reflux  and gastritis. Routine blood tests were normal. Lesion intra operation: Tumor juxta gastric cardia, located in lesser sac measuring 3-4 cm. Complete surgical excision. Histopathological result and immunohistochemistry: ): S-100 (+), SOX10(+), Ki 67 (+) 2%.

Conclusion: Schwannoma of hepatoduodenal ligament  and schwannoma of lesser sac are rare and benign tumors (9 cases over world). The symptoms are not specific. Ctscan showed well=defined, heterogenous mixed  solid-cystic tumor located juxta hepato-duodenal ligament, posterior to  pancreatic head and  D1-D2 duodenum or tumor of lesser sac. Surgical excision (Ro resection) is the only curative method (laparotomy or laparoscopy). Immunohistochemistry S-100 (+), SOX10 (+), Ki67 (+) 2-3%.