An initial abdominal

sonography showed a well-defined, cystic-appearance mass lesion with a diameter of 6 cm localized between the portal hilus and the pancreatic head. On contrast-enhanced computed tomography (CT), a well-defined hypodense lesion about 6 cm adjacent to the pancreatic head existed with a mural solid nodular component (Figure 1A). A conventional magnetic resonance imaging (MRI) and a diffusion-weighted MRI (DW-MRI) were performed to determine the nature of the lesion and the relationship between adjacent structures. Contrast-enhanced and diffusion-weighted images revealed a lesion located in the gastroduodenal ligament with enhancing septa and solid mural component with diffusion restriction (Figures 1B–D). BMS-354825 mw The lesion was assumed as malignant according to these imaging features and the patient was prepared for surgery. On histopathologic examination, the tumor was diagnosed as a benign schwannoma (Figure 2). Schwannomas, also known as neurilemmomas, are benign nerogenic tumors that arise from Schwann cells that line the sheaths of peripheral nerves. Schwannomas are commonly located in the soft tissues of the head and neck, extremities, and mediastinum. Although a frequent tumor, schwannomas are seldom found in the abdomen. Intra-abdominal schwannomas are very rare tumors that are difficult to diagnose preoperatively

Silmitasertib cell line with certainty because of the lack of specific radiological features. The main

differential diagnosis of schwannoma in the abdominal cavity should include gastrointestinal stromal tumor (GIST), primary or secondary lymphoma, and adenocarcinoma. Ultrasonography, CTs, and MRIs are effective tools for evaluating the lesions found in the abdomen preoperatively in localization and differentiating diagnoses. A DW-MRI is being increasingly used in the evaluation of benign or malignant states. This kind of MRI measures the rate of microscopic water diffusion in tissues. Tumor cellularity reduces the extracellular matrix and therefore may play a major role in diffusion restriction. In this case, the well-encapsulated cystic mass showed enhancing septa and a solid mural component with diffusion restriction. Thus, the lesion was assumed to be malignant according to these imaging features, but the MCE tumor was diagnosed as a benign schwannoma after a histopathologic examination. However, a DW-MRI provided more information in differentiating the benign or malignant conditions. Misdiagnosis for benign processes as in this case should be taken into account, and thus histopathological verification is often still required because of the importance of excluding malignancies, especially before informing the patient. Contributed by “
“A gastroscopy was performed on a 76 year old lady one year after being diagnosed with celiac disease, due to recurrent gut symptoms, despite full compliance with gluten-free diet.