Surgical Case Reports (Mar 2019)

Resection of a pancreatic capillary lymphatic malformation through a partial pancreatectomy: a case report

  • Shigeto Ochiai,
  • Koichi Tomita,
  • Masashi Nakagawa,
  • Itsuki Koganezawa,
  • Kei Yokozuka,
  • Takahiro Gunji,
  • Kosuke Hikita,
  • Yosuke Ozawa,
  • Toshimichi Kobayashi,
  • Toru Sano,
  • Rina Tsutsui,
  • Naokazu Chiba,
  • Midori Wakiya,
  • Hiroshi Hirano,
  • Shigeyuki Kawachi

DOI
https://doi.org/10.1186/s40792-019-0603-z
Journal volume & issue
Vol. 5, no. 1
pp. 1 – 6

Abstract

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Abstract Background Pancreatic vascular malformation causes epigastric pain, pancreatitis, portal vein hypertension, bleeding, and rupture. It is a rare disease, with most pancreatic vascular malformations being arteriovenous malformations (AVMs) and the other types of malformations being rare. We report a case of capillary lymphatic malformation (CLM) in the pancreatic uncinate process. Case presentation A 74-year-old woman, who presented with complaints of repeated upper abdominal pain, was admitted to our institution. Contrast-enhanced dynamic computed tomography (CT) scan revealed that the tumor in the pancreatic uncinate process had a poor contrast effect in the arterial phase and a small contrast effect in the equilibrium phase, which are suggestive of a benign disease-like vascular malformation. However, we suspected that it could possibly be a malignant tumor because the tumor size tended to increase over time; thus, we decided to perform a surgery. We resected the tumor through a partial resection of the pancreas. Macroscopically, the cut surface of the tumor had a spongioid appearance. Histopathological examination findings showed a mixed shape of small capillaries and lymphatic ducts. The patient was diagnosed with CLM according to the International Society for the Study of Vascular Anomalies (ISSVA) classification, based on the histological appearance and immunostaining findings. The postoperative course of the patient was uneventful. Conclusions We reported a case of pancreatic vascular malformation, specifically a CLM, which was completely resected through a partial pancreatectomy.

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