Rationale: Schwannomas are neoplasms that originate from Schwann cells of the peripheral nerve sheath with a low malignant potential. Considering that Schwannomas often occur in the upper extremities, trunk, head, and neck, but in the hepatoduodenal ligament has seldom been reported.
Patient concerns: A 70-year-old man was referred to our hospital for further evaluation of distension in upper abdomen. Abdominal ultrasonography reported that an anechoic mass was found between the pancreatic head and portal vein, which was measured to be about 5.5 × 4 × 4 cm. No blood flow signal was found within the mass by color doppler ultrasound. Subsequently, abdominal contrast enhanced computed tomography revealed that a well-defined round soft-tissue was above the pancreatic head and adjacent to the common heapatic artery, and it had no obvious enhancement in the arterial phase and portal phase.
Diagnoses: Schwannomas in the hepatoduodenal ligament.
Interventions: After the work-up of a multidisciplinary team, a right complete excision was carried out and schwannoma was diagnosed by pathology.
Outcomes: The patient's postoperative course was uneventful, and he left the hospital 10 days after the operation. Additionally, at the time of writing, recurrence was not observed with a follow-up of 17 months.
Lessons: schwannomas in the hepatoduodenal ligament are extremely rare with benign behavior. Surgical resection is the gateway to cure it; however, accurate preoperative diagnosis of the schwannomas in the hepatoduodenal ligament is a huge challenge because neither the clinical symptoms nor the imaging manifestations are specific.