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      Laparoscopic resection of schwannoma in the hepatoduodenal ligament: a case report

      case-report

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          Abstract

          Background

          The occurrence of schwannomas in the hepatoduodenal ligament is rare, and its preoperative accurate diagnosis is difficult. Only few cases have been treated with laparoscopic surgery.

          Case presentation

          A 54-year-old man visited our hospital following abnormal abdominal computed tomography findings. He had no complaints, and his laboratory investigations were normal. Abdominal contrast-enhanced computed tomography revealed a tumor with enhancement at the margin of the hepatoduodenal ligament. The abdominal magnetic resonance imaging findings of the tumor showed hypointensity on the T1-weighted images and mixed hypointensity and hyperintensity on the T2-weighted fat-suppression images. Positron emission tomography showed localized accumulation of fludeoxyglucose only in the hepatoduodenal ligament tumor. The patient underwent laparoscopic tumor resection for accurate diagnosis. Histopathologically, the tumor was mainly composed of spindle cells, which were strongly positive for S-100 protein on immunohistochemical staining. The patient was discharged without any postoperative complications on day 5.

          Conclusions

          Complete tumor resection is essential for schwannomas to avoid recurrence. Laparoscopic surgery is useful for schwannomas occurring in the hepatoduodenal ligament and can be performed safely by devising an appropriate surgical method.

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          Most cited references31

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          Benign solitary Schwannomas (neurilemomas).

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            Neurogenic tumors in the abdomen: tumor types and imaging characteristics.

            There is a broad spectrum of neurogenic tumors that involve the abdomen. These tumors can be classified as those of (a) ganglion cell origin (ganglioneuromas, ganglioneuroblastomas, neuroblastomas), (b) paraganglionic system origin (pheochromocytomas, paragangliomas), and (c) nerve sheath origin (neurilemmomas, neurofibromas, neurofibromatosis, malignant nerve sheath tumors). Abdominal neurogenic tumors are most commonly located in the retroperitoneum, especially in the paraspinal areas and adrenal glands. All of these tumors except neuroblastomas and ganglioneuroblastomas are seen in adult patients. Abdominal neurogenic tumor commonly manifests radiologically as a well-defined, smooth or lobulated mass. Calcification may be seen in all types of neurogenic tumors. The diagnosis of abdominal neurogenic tumor is suggested by the imaging appearance of the lesion, including its location, shape, and internal architecture. Benign and malignant neurogenic tumors are difficult to differentiate unless distant metastatic foci are seen. For malignant tumors, imaging modalities other than computed tomography (CT) and magnetic resonance (MR) imaging may be necessary for staging. However, because most neurogenic tumors in adults are benign, CT and MR imaging can be used to develop a differential diagnosis and help determine the immediate local extent of tumor. Copyright RSNA, 2003.
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              Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review.

              Peripheral neurogenic tumors include neurilemoma, neurinoma, and malignant peripheral nerve sheath tumors. All neurogenic tumors share common imaging features. Although differentiation between them is difficult, neurogenic origin can be suggested from their imaging appearances, including fusiform shape, relation to the nerve, "split-fat" sign, associated muscle atrophy and intrinsic imaging characteristics including "target sign" as well as from lesion location along a typical nerve distribution. Our purpose is to make an overview of imaging findings of each type of peripheral nerve sheath tumor with emphasis on characteristic signs and correlate with histologic features. Morton's neuroma and intraneural ganglion are also included as tumors of nerve origin.
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                Author and article information

                Contributors
                tomozo19880818@gmail.com
                koishi@enjoy.ne.jp
                impossibleswimmer@gmail.com
                yn_futt0711@yahoo.co.jp
                okimoto1221@gmail.com
                silentman1087@yahoo.co.jp
                ngywc515@ybb.ne.jp
                seiji919fuji@yahoo.co.jp
                nishi-toshi@chugokuh.johas.go.jp
                hohdan@hiroshima-u.ac.jp
                tsktfukuda@gmail.com
                Journal
                Surg Case Rep
                Surg Case Rep
                Surgical Case Reports
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2198-7793
                19 August 2021
                19 August 2021
                December 2021
                : 7
                : 187
                Affiliations
                [1 ]GRID grid.414468.b, ISNI 0000 0004 1774 5842, Department of Surgery, , Chugoku Rosai Hospital, ; Hirotagaya 1-5-1, Kure, Hiroshima, Japan
                [2 ]GRID grid.414468.b, ISNI 0000 0004 1774 5842, Department of Pathology, , Chugoku Rosai Hospital, ; Hiroshima, Japan
                [3 ]GRID grid.257022.0, ISNI 0000 0000 8711 3200, Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, , Hiroshima University, ; Kasumi 1-2-3 Minami-ku, Hiroshima, Japan
                Author information
                http://orcid.org/0000-0003-1159-3908
                Article
                1271
                10.1186/s40792-021-01271-y
                8377106
                34410526
                643626d1-fc56-427b-9a80-921d38166a34
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 21 May 2021
                : 12 August 2021
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2021

                schwannoma,hepatoduodenal ligament,laparoscopic surgery

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