Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2008; 14(18): 2932-2934
Published online May 14, 2008. doi: 10.3748/wjg.14.2932
A case of invasive hemolymphangioma of the pancreas
Yoshikazu Toyoki, Kenichi Hakamada, Shunji Narumi, Masaki Nara, Daisuke Kudoh, Keinosuke Ishido, Mutsuo Sasaki
Yoshikazu Toyoki, Kenichi Hakamada, Shunji Narumi, Masaki Nara, Daisuke Kudoh, Keinosuke Ishido, Mutsuo Sasaki, Department of Gastroenterological Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 0368652, Japan
Author contributions: Toyoki Y, Hakamada K, Narumi S, Nara M, Kudoh D, Ishido K and Sasaki M contribured in this case, images and wrote the paper.
Correspondence to: Yoshikazu Toyoki, Dr, Department of Gastroenterological Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 0368652, Japan. ytoyoki@cc.hirosaki-u.ac.jp
Telephone: +81-172-395079
Fax: +81-172-395080
Received: December 15, 2007
Revised: March 19, 2008
Published online: May 14, 2008
Abstract

Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding.

Keywords: Hemolymphangioma; Duodenal invasion; Gastrointestinal bleeding