© The Author (2008). Published by Oxford University Press. All rights reserved
A Case of Neurilemoma at the Celiac Tripod
Hepatobiliary and Pancreatic Surgery Division,
National Cancer Center Hospital,
Tokyo, Japan
A 49-year-old woman underwent polypectomy for a sigmoid colon cancer involving the submucosal layer. Five years after polypectomy, a follow-up dynamic CT scan revealed a heterogeneous low-attenuated tumor, measuring 4 cm in size, adjacent to the common hepatic artery, the left gastric artery, the splenic artery, the left gastric vein and the pancreatic body (Fig. 1, arrowhead). We suspected a retroperitoneal neurogenic tumor originating from the nerve plexus of the celiac artery. A surgical resection was conducted, because the tumor gradually increased its size during the 5 years and we could not rule out malignancy.
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At laparotomy, the tumor tightly adhered to the tributaries of the celiac artery and the pancreatic parenchyma, but we successfully removed the tumor preserving the celiac tripod arteries and pancreas. The resected specimen showed an encapsulated, elastic-soft and spherical mass measuring 40 x 35 x 25 mm. Cross-sections of the tumor had clear circumference and it was yellowish white with cystification and micro hemorrhages in the center. Microscopically, the tumor consisted of the proliferation of spindle-shaped cells with alternating Antoni A and B areas (Fig. 2). The tumor was pathologically diagnosed as a benign schwannoma (neurilemoma).
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