title: Porta hepatic schwannoma: case report and a 30-year review of the literature yielding 15 cases.
abstract: BACKGROUND
  Schwannomas located in the periportal region are extremely rare. Only 14 cases have been reported in the medical literature worldwide. Cases of porta hepatic schwannomas reported in the literature worldwide were reviewed. As a result, it is very challenging for surgeons to make a preoperative diagnosis due to its rarity and nonspecific imaging manifestations.
  
  
  METHODS
  A 57-year-old Chinese female was admitted to our institution with complaint of upper abdominal distension and the abdominal CT in the local hospital revealed a hypodense mass in the porta hepatis. A fine needle aspiration (FNA) was made to confirm the diagnosis, but the result was just suggestive of spindle cell neoplasia. Eventually, the patient underwent surgery and postoperative pathology confirmed schwannoma in porta hepatis. The patient recovered uneventfully with no evidence of recurrence after a follow-up period of 41 months.
  
  
  CONCLUSIONS
  It is essential for the final diagnosis of porta hepatic schwannomas to combine histological examination with immunohistochemistry after surgery. The main treatment of porta hepatic schwannomas is complete excision with free margins and no lymph node dissection. In some cases, biliary reconstruction or the proper hepatic and the gastroduodenal artery resection was performed because the tumor was inseparably attached to the extrahepatic bile duct or the proper hepatic and the gastroduodenal artery. Malignant transformation of schwannomas is very rare and the overall prognosis is satisfactory.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.|Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Sheng-yong
authors.initials: SY
authors.lastname: Yin
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.|Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Zheng-long
authors.initials: ZL
authors.lastname: Zhai
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.|Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Kui-wu
authors.initials: KW
authors.lastname: Ren
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.|Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Yun-chuan
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.|Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Da-long
authors.initials: DL
authors.lastname: Wan
authors.affiliation: Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Li-jun
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China. shusenzheng123@sina.com.|Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China. shusenzheng123@sina.com.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China. shusenzheng123@sina.com.
authors.forename: Shu-sen
authors.initials: SS
authors.lastname: Zheng
mesh_terms: D017734:Bile Ducts, Extrahepatic / Q000473:pathology* / Q000601:surgery; D005260:Female; D006499:Hepatic Artery / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology* / Q000601:surgery; D011379:Prognosis
keywords: Hepatoduodenal ligament; Porta hepatis; Proper hepatic artery; S-100; Schwannomas