Korean J Hepatobiliary Pancreat Surg.  2016 May;20(2):93-96. 10.14701/kjhbps.2016.20.2.93.

Incidental detection of pancreatic hemangioma mimicking a metastatic tumor of renal cell carcinoma

Affiliations
  • 1Department of Hepatobiliary and Pancreatic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. KSKIM88@yuhs.ac
  • 2Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Adult pancreatic hemangioma is a rare disease. We presented a case of a woman with pancreatic tail mass mimicking a distant metastasis from the kidney. A 68-year-old woman was found with a left kidney mass on medical checkup. Computed tomography scan showed a 4.3 cm-sized mass in the left kidney, suggesting renal cell carcinoma (RCC), and a strongly enhancing tiny nodule in the pancreatic tail. We could not rule the possibility of RCC metastasis, hence, surgical resection of the pancreatic mass simultaneously with radical nephrectomy for RCC was conducted. Gross pathologic examination revealed hemangioma. Immunohistochemistry revealed that the tumor was positive for CD34, CD31 and factor VIII-related antigen. There were no significant postoperative events, and the patient was discharged on postoperative day 7 without any complications. Treatment strategies for pancreatic hemangioma have not been established. To our knowledge, this was the first case report of asymptomatic pancreatic hemangioma. In previous literature, treatment differed on a case-by-case basis, ranging from observation to surgical resection. The most important factor in deciding whether to perform surgery is possibly risk-benefit effectiveness; however, tumor location, patient symptoms, and other factors are also important.

Keyword

Pancreas; Hemangioma; Adult hemangioma; Incidental discovery; CD34

MeSH Terms

Adult
Aged
Carcinoma, Renal Cell*
Female
Hemangioma*
Humans
Immunohistochemistry
Incidental Findings
Kidney
Neoplasm Metastasis
Nephrectomy
Pancreas
Rare Diseases
Tail
von Willebrand Factor
von Willebrand Factor

Figure

  • Fig. 1 Imaging study and gross morphology. (A) Axial contrast-enhanced CT scan during the arterial phase shows a strongly enhancing tiny nodule in the pancreatic tail (arrowhead); (B) Gross specimen; pancreatic hemangioma confined to the pancreas (arrow).

  • Fig. 2 Immunohistochemical stain shows a cavernous, ectatic endothelial neoplasm arising amid pancreatic parenchymal tissue. (A) CD31 (100×); (B) CD34 (100×); (C) factor VIII-related antigen (100×); and (D) D2-40 (100×).


Cited by  1 articles

Pancreatic Hemangioma Suspected of Neuroendocrine Tumor
Mo Ah Jeong, Jun Kyu Lee, Ji Hyung Nam, Dong Kee Jang, Yun Jeong Lim, Jeong-Ju Lee, Eo-Jin Kim
Korean J Gastroenterol. 2020;76(1):46-48.    doi: 10.4166/kjg.2020.76.1.46.


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