Korean J Radiol.  2007 Jun;8(3):242-245. 10.3348/kjr.2007.8.3.242.

Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

• Kwon JH
• Ryu SW
• Kang YN

• KMID: 1779441
• DOI: http://doi.org/10.3348/kjr.2007.8.3.242

Abstract

Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metastasis.

Keyword

Traumatic neuroma; Celiac trunk; Gastrectomy

MeSH Terms

Celiac Plexus/*pathology/surgery
Diagnosis, Differential
Gastrectomy
Gastric Bypass
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasms, Post-Traumatic/*diagnosis/surgery
Neuroma/*diagnosis/surgery
Peripheral Nervous System Neoplasms/*diagnosis/surgery
Positron-Emission Tomography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 56-year-old man with traumatic neuroma around the celiac trunk. A. A contrast-enhanced abdominal CT scan in the arterial phase showed no mass present around the celiac trunk 5 months previously. B, C. Contrast-enhanced abdominal CT scans in the arterial phase show a lobulated hypoattenuating soft tissue mass in the celiac region encasing the common hepatic artery, splenic artery, gastroduodenal artery, and the proper hepatic artery. D, E. Contrast-enhanced abdominal CT scans in the portal phase (D) and equilibrium phase (E) show a mild homogeneous enhancement of this mass. F. Volume-rendering CT angiography shows that the celiac trunk and its tributaries are patent without vessel wall irregularities, or vessel caliber stenosis. G. Fluorodeoxyglucose (FDG)-positron emission tomography (PET) image shows no increased uptake around the celiac trunk with a mean standardized uptake value of 3.2. H. The resected celiac mass is composed of several pieces of irregular pale tan to yellow firm tissue, measuring 3.5 × 3.0 × 1.0 cm in aggregates. I, J. Microscopically, the celiac mass consists of small (arrows) and large (asterisk) proliferating fascicles of nerve in a background of collagen and fat tissue (Hematoxylin & Eosin staining, × 100). The celiac mass is composed of a haphazard proliferation of nerve fascicles, including axons with their investitures of myelin, Schwann cells, and fibroblasts (Hematoxylin & Eosin staining, × 200).

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