Incidental detection of pancreatic hemangioma mimicking a metastatic tumor of renal cell carcinoma.

Abstract

Adultpancreatichemangiomais a rare disease. We presented a case of a woman withpancreatictail massmimickinga distant metastasis from the kidney. A 68-year-old woman was found with a left kidney mass on medical checkup. Computed tomography scan showed a 4.3 cm-sized mass in the left kidney, suggestingrenalcellcarcinoma(RCC), and a strongly enhancing tiny nodule in thepancreatictail. We could not rule the possibility of RCC metastasis, hence, surgical resection of thepancreaticmass simultaneously with radical nephrectomy for RCC was conducted. Gross pathologic examination revealedhemangioma. Immunohistochemistry revealed that thetumorwas positive for CD34, CD31 and factor VIII-related antigen. There were no significant postoperative events, and the patient was discharged on postoperative day 7 without any complications. Treatment strategies forpancreatichemangiomahave not been established. To our knowledge, this was the first case report of asymptomaticpancreatichemangioma. In previous literature, treatment differed on a case-by-case basis, ranging from observation to surgical resection. The most important factor in deciding whether to perform surgery is possibly risk-benefit effectiveness; however,tumorlocation, patient symptoms, and other factors are also important.