# Retroduodenal and Juxtapancreatic Schwannomas: Clinical and Surgical Insights From Three Cases

## TL;DR

This paper reports three rare cases of schwannomas near the pancreas and duodenum, highlighting their diagnostic challenges and successful surgical treatment.

## Contribution

The study provides clinical and surgical insights into retroduodenal and juxtapancreatic schwannomas through a case series.

## Key findings

- Schwannomas near the pancreas and duodenum can mimic pancreatic tumors on imaging.
- Complete surgical excision of these tumors leads to smooth recovery and no recurrence.
- Histopathology and immunohistochemistry are essential for confirming schwannoma diagnosis.

## Abstract

Retroperitoneal schwannomas, as such, are a rare entity, and those located near the pancreas and duodenum may emulate pancreatic tumors on imaging, making a diagnosis, surgical planning, and patient counselling challenging. Their low incidence and nonspecific clinical presentation often hinder preoperative identification.

This case series presents three female patients who presented with either mild epigastric discomfort or incidental findings during routine health evaluations. Contrast-enhanced CT scans revealed well-circumscribed, heterogeneous cystic lesions in the retroperitoneal space adjacent to the pancreas and duodenum. Each patient underwent a complete surgical excision of the tumor. Histopathological examination confirmed schwannomas, exhibiting typical Antoni A and Antoni B areas, as well as Verocay bodies. S-100 protein positivity was noted on immunohistochemical staining, supporting the diagnosis of a benign nerve sheath tumor. All patients experienced a smooth recovery after surgery, and no recurrences were noted during the follow-up period lasting for a year. These cases emphasise three different locations of retroperitoneal schwannomas: juxtapancreatic, retroduodenal, and posterior to the head of the pancreas, between the second part of the duodenum and the right kidney. A definitive diagnosis relies on histopathological and immunohistochemical findings. Surgical excision remains the preferred treatment and is associated with excellent outcomes.