Incidental detection of a rare pancreatic PEComa: A case report

Le résumé fourni par la source

Pancreatic perivascular epithelioid cell tumour (PEComa) is an exceptionally rare mesenchymal neoplasm, with fewer than 50 cases reported in the literature to date. We present the case of a 53-year-old female with a background of coeliac disease, anxiety and chronic back pain who was found to have an incidental pancreatic body lesion on magnetic resonance imaging (MRI), which was performed to characterise a hepatic abnormality detected on computed tomography (CT) for persistent epigastric pain. Endoscopic ultrasound with fine needle biopsy (EUS-FNB) demonstrated a 9mm hypoechoic lesion in the pancreatic body, with histopathology and immunohistochemistry establishing a pre-operative diagnosis of PEComa. The patient underwent a successful laparoscopic spleen-preserving distal pancreatectomy. Histopathology confirmed complete excision of a benign PEComa satisfying no malignant criteria on Folpe classification. This case highlights the diagnostic challenge posed by pancreatic PEComa, the critical role of pre-operative tissue diagnosis via EUS-FNB, complete surgical resection and the importance of maintaining a broad differential when investigating pancreatic lesions of uncertain aetiology.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.