title: A case of invasive hemolymphangioma of the pancreas.
abstract: Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding.
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 0368652, Japan. ytoyoki@cc.hirosaki-u.ac.jp
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Toyoki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hakamada
authors.forename: Shunji
authors.initials: S
authors.lastname: Narumi
authors.forename: Masaki
authors.initials: M
authors.lastname: Nara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kudoh
authors.forename: Keinosuke
authors.initials: K
authors.lastname: Ishido
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Sasaki
mesh_terms: D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D008202:Lymphangioma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*