Pancreatic schwannoma: a diagnostic dilemma of pancreatic head tumour

Pancreatic schwannoma is usually a benign neoplasm presenting with non-specific symptoms, and preoperative diagnosis is often difficult to establish. The imaging features can overlap from benign cystic lesions to ductal adenocarcinomas. Diagnosis is mainly histological with characteristic microscopic appearance (aggregates of spindle-shaped cells) and immunostaining (positive for S100 and SOX-10) suggestive of a peripheral nerve sheath tumour. Due to diagnostic ambiguity, surgical resection is often mandated. We present a case of a female patient in her sixth decade of life presenting with symptoms pointing towards a malignant pancreatic head tumour. She underwent formal pancreatoduodenectomy, which on histopathological examination was diagnosed as a schwannoma.