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Retroperitoneal Schwannoma Presents as a Peripancreatic Cystic Structure: The Utility of EUS/FNA in the Diagnosis

Mohamed Sultan, Heather Pemberton, Walid Chalhoub, Abdulhameed Al-Sabban, Jay Zeck, Nadim Haddad and Jill Smith

Retroperitoneal schwannomas are extremely rare tumors that arise from the Schwann cell of the peripheral nerves. Patients are typically asymptomatic, however, large tumors may lead to the development of abdominal pain or obstructive symptoms. Herein we describe a case of a 57 year-old male with a known peripancreatic cystic mass presenting with new onset abdominal pain and a CT demonstrating a 40 × 42 mm peripancreatic cystic structure previously 17 × 20 mm. Endoscopic ultrasound with fine needle aspiration was performed and cytological examination revealed a peripheral nerve sheath tumor. The patient underwent uneventful laparoscopic resection. Analysis of the surgical specimen revealed a spindle cell tumor with positive S100, negative CD117/CD34 and pancytokeratin consistent with a schwannoma