Saturday, October 10, 2009

SCHWANNOMA of LESSER OMENTUM MIMICKING LEFT LOBE of LIVER TUMOR, Dr LE THONG NHAT, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 55yo female patient from Baclieu province went to Medic Center because of an epigastric mass which made abdominal distension, loss of weight and dyspepsia.

Ultrasound represented a hypoechoic and mixed mass in relation with the left lobe of the liver in 13x14cm, few vascularisation and some small cysts within its more echoic center.



MSCT confirmed that a mass, in close relation with the left lobe of the liver, bent downward the duodenum, the head of the pancreas and the celiac artery. The mass caught the contrast media but was in lower attenuation than the normal liver parenchyma.



In operation, the mass appeared in the lesser omentum and beneath the left lobe of the liver and was removed in 13x18cm, reliably solid, ovoid shape with its own capsula.









Histopathological results: The mass concludes some schwann cells which have lozenge shape, few cytoplasma, flat and small nuclei, gather in bundle, spiral or hedge. There are degenerating mucinuous area of stroma with some macrocytes and asteroid cells.

Immunohistochemistry staining = CD 117 (-), NSE (+), Desmin (-) proves a mesenteric Schwannoma for the lesser omentum tumor.

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