Adult pancreatic hemangioma: a rare case report and literature review

Abstract

Background: Adult pancreatic hemangioma is an extremely rare type of benign vascular tumor. To date, about 20 cases have been reported in the English literature. Adult patients with pancreatic hemangiomas usually have no specific symptoms, particularly in early stages. Therefore, it is difficult to detect and diagnose these lesions, which usually are identified during cross sectional imaging for an apparently unrelated causes or when biliary obstruction occurs because of compression by a tumor.

Case presentation: This study presents the case of a 52-year-old female with a chief complaint of epigastric pain. Contrast-enhanced computed tomography revealed a well-defined mass with mildly inhomogeneous enhancement in the body of the pancreas. Endoscopic ultrasonography showed calcifications in the lesion, and a few small vessels were detected by Doppler imaging. The patient received a central pancreatectomy, and pathological examination confirmed the diagnosis of pancreatic hemangioma.

Conclusion: In this report, we reviewed the clinical manifestations, radiologic features, preoperative diagnosis, pathologic characteristics, and surgical treatment of adult pancreatic hemangioma.

Keywords: CD34; Computed tomography; Endoscopic ultrasonography; Pancreatic hemangioma.

Fig. 1

Dynamic CT scans of the pancreas showed a well-defined mass in the body of the pancreas. a Plain scan showed speckled and lamellar calcifications in the mass. b Arterial phase revealed mildly inhomogeneous enhancement. c Venous phase. d Delayed phase showed slight dilation of the main pancreatic duct

Fig. 2

a The tumor was located in the pancreatic body and was adjacent to the gastric wall intraoperatively. b The gross pathologic specimen showed a 5.0 cm × 4.5 cm hemangioma containing multiloculated cysts

Fig. 3

Histopathology. (a) H&E staining of the border of the tumor and normal pancreas (× 40 magnification). Strong positive CD34 staining (b) and positive CK staining (C) on the endothelial surfaces proved the vascular origin (× 100 magnification). Negative D2–40 staining excluded lymphangiomas (D, × 100 magnification)