Neurinoma of the pancreas is very rare lesion with only 11 cases having been reported to date in Japan. Here we report one such case that was found in a patient with primary aldosteronism.
A 37-year-old woman was admitted to our hospital because of hypertension and hypokalemia along with an increased blood concentration of aldosterone (34ng/dl). The patient was definitely diagnosed as having primary aldosteronism due to a left adrenal adenoma by hormonal examinations and radiological imaging tests.
During the work-up a mass lesion measuring 3cm in diameter on ultrasonography was incidentally detected in the pancreas haed. Computed tomography of he abdomen showed the tumor being located in the dorsal portion of the pancreas head. Celiac arteriography demonstrated a neovascularity of the tumor, though neigher irregularity of the vessels wall or tumor staining in the capillary phase was seen. Endoscopic retrograde pancreatography showed a mild degree of narrowing of main pancreatic duct in the pancreas head. No hormonal abnormalities other than then hyperaldosteronism were found.
The patient underwent pancreaticoduodenectomy along with left adrenectomy under the preoperative diagnosis of primary aldosteronism and a non-functioning endocrine tumor in the pancreas head. Microscopic examination confirmed that the tumor was neurinoma arising form the pancreas head.