Schwannomatosis presenting as pancreatic and submandibular gland schwannoma.
Schwannomatosis is a well-established third form of neurofibromatosis, characterized by the presence of multiple non-vestibular, non-intradermal schwannomas, often associated with chronic pain. Herein, we report a 41-year-old man with a history of paternal neurofibromatosis 1, who presented with partially cystic tumors in the pancreas and in the right submandibular gland. Besides, he complained of neuropathic pain in the right inguinal and suprapubic area. Magnetic resonance imaging revealed multiple intradural-extramedullary tumors at the cervical, thoracic and lumbar spinal canal, suggestive of schwannomas. The vestibular nerves were not involved. Pathological examination of the glandular tumors disclosed benign schwannomas. These tumors had substantial myxoid stroma and prominent cystic change, and showed a mosaic pattern of loss of INI1/SMARCB1 expression by immunohistochemistry. Later, the patient developed three nodules in the right lung which were interpreted as schwannomas. To our knowledge, this is the first report of schwannomatosis presenting as pancreatic and salivary gland schwannomas.
Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain. Electronic address: apavbj@humv.es.
José Fernando
JF
Val-Bernal
Marta
M
Mayorga
María José
MJ
Sedano-Tous
D000328:Adult; D006801:Humans; D008297:Male; D009442:Neurilemmoma / Q000150:complications / Q000209:etiology* / Q000473:pathology; D017253:Neurofibromatoses / Q000150:complications* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000209:etiology* / Q000473:pathology; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology; D013365:Submandibular Gland Neoplasms / Q000209:etiology* / Q000473:pathology
Neurofibromatosis; Pancreas; Salivary gland; Schwannoma; Schwannomatosis