Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of pancreatic Schwannoma: A retrospective study of three cases

BACKGROUND AND OBJECTIVES: Pancreatic schwannomas are a rare disease. They consist of a tumor originating from Schwann cells, and usually, the diagnosis comes from a surgical resection since the image alone is not characteristic. The endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) can provide a tissue sample of the tumor by minimal invasive examination. This study shows the diagnosis of three cases of pancreatic schwannomas by EUS-FNA. METHODS: This retrospective study shows the diagnosis of three consecutive pancreatic schwannomas by EUS-FNA in patients that had an incidentalome. RESULTS: Three patients were diagnosed with schwannoma in a private clinic in Rio de Janeiro. One of the lesions was solid, situated in the head and neck of the pancreas, hypoechoic, with anechoic areas of cystic degeneration. The second lesion was cystic, hypoechoic, situated in the neck of the pancreas, with exophytic growing. The third lesion was cystic and solid, situated in the body of the pancreas. Fine-needle aspirations were made with a standard 19G needle and revealed cells that expressed S-100 protein, suggestive for schwannoma. CONCLUSION: The EUS-FNA can provide tissue sample of the tumor by minimal invasive examination and make this rare diagnose in the pancreas. It should be considered in the differential diagnosis of solid and cystic lesions of the pancreas.