The typical and atypical CT features of pancreatic schwannoma: pearls and pitfalls

Pancreatic schwannomas (PSs) are rare, benign nerve sheath tumors that can be encountered as incidental findings on imaging, and their imaging features overlap with other solid and cystic pancreatic lesions. This often leads to preoperative misdiagnosis. On computed tomography (CT), which is often the first modality to detect these tumors, PS classically appears as a well-defined, round or oval, encapsulated mass without pancreatic ductal dilation when small. Degenerative changes in larger lesions can produce cystic change, septations, calcification, and hemorrhage. In this pictorial essay, we present the CT spectrum of PS through a series of illustrative cases, spanning typical and atypical appearances, to help radiologists recognize this rare tumor and include it as a benign differential diagnosis for pancreatic masses.