Language-Independent Acoustic Biomarkers for Quantifying Speech Impairment in Huntington's Disease.

PURPOSE: Changes in voice and speech are characteristic symptoms of Huntington's disease (HD). Objective methods for quantifying speech impairment that can be used across languages could facilitate assessment of disease progression and intervention strategies. The aim of this study was to analyze acoustic features to identify language-independent features that could be used to quantify speech dysfunction in English-, Spanish-, and Polish-speaking participants with HD. METHOD: Ninety participants with HD and 83 control participants performed sustained vowel, syllable repetition, and reading passage tasks recorded with previously validated methods using mobile devices. Language-independent features that differed between HD and controls were identified. Principal component analysis (PCA) and unsupervised clustering were applied to the language-independent features of the HD data set to identify subgroups within the HD data. RESULTS: Forty-six language-independent acoustic features that were significantly different between control participants and participants with HD were identified. Following dimensionality reduction using PCA, four speech clusters were identified in the HD data set. Unified Huntington's Disease Rating Scale (UHDRS) total motor score, total functional capacity, and composite UHDRS were significantly different for pairwise comparisons of subgroups. The percentage of HD participants with higher dysarthria score and disease stage also increased across clusters. CONCLUSION: The results support the application of acoustic features to objectively quantify speech impairment and disease severity in HD in multilanguage studies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25447171.

Functional Characteristics of the Nav1.1 p.Arg1596Cys Mutation Associated with Varying Severity of Epilepsy Phenotypes.

Mutations of the SCN1A gene, which encodes the voltage-dependent Na+ channel's α subunit, are associated with diverse epileptic syndromes ranging in severity, even intra-family, from febrile seizures to epileptic encephalopathy. The underlying cause of this variability is unknown, suggesting the involvement of additional factors. The aim of our study was to describe the properties of mutated channels and investigate genetic causes for clinical syndromes' variability in the family of five SCN1A gene p.Arg1596Cys mutation carriers. The analysis of additional genetic factors influencing SCN1A-associated phenotypes was conducted through exome sequencing (WES). To assess the impact of mutations, we used patch clamp analysis of mutated channels expressed in HEK cells and in vivo neural excitability studies (NESs). In cells expressing the mutant channel, sodium currents were reduced. NESs indicated increased excitability of peripheral motor neurons in mutation carriers. WES showed the absence of non-SCA1 pathogenic variants that could be causative of disease in the family. Variants of uncertain significance in three genes, as potential modifiers of the most severe phenotype, were identified. The p.Arg1596Cys substitution inhibits channel function, affecting steady-state inactivation kinetics. Its clinical manifestations involve not only epileptic symptoms but also increased excitability of peripheral motor fibers. The role of Nav1.1 in excitatory neurons cannot be ruled out as a significant factor of the clinical phenotype.

Hidradenitis suppurativa - biologic therapy and other available treatment options.

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease which is characterized by painful, recurrent nodules and abscesses. The overall prevalence of HS is estimated to be 11 per 100 000 individuals in the United States and 4% of the world's population. Women are three times more affected than men, especially patients between 18 and 29 years. Similarly to acne vulgaris, HS is primarily associated with follicular occlusion, which results from a number of biological processes, including follicular epithelial hyperplasia and hyperkeratinization. There are numerous available treatment options for cutaneous lesions in the course of HS. A combination of conservative therapy and appropriate surgical treatment conducted by an experienced surgeon ensures the best possible clinical outcomes. Presently, biologic therapy is the most effective pharmacological treatment in patients with a moderate-to-severe course of the disease. Numerous ongoing clinical trials provide hope for greater availability of new biologic therapy methods.

Factors Contributing to Risk of Persistence of Positive and Negative Symptoms in Schizophrenia during Hospitalization.

The aim of the study was to evaluate factors that may contribute to the persistence of positive, negative and other psychopathological symptoms of schizophrenia. All patients were treated in general psychiatric wards between January 2006 and December 2017. The initial study sample comprised of the medical reports of 600 patients. The main, specified inclusion criterion for the study was schizophrenia as a discharge diagnosis. Medical reports of 262 patients were excluded from the study due to no neuroimaging scans being available. The symptoms were categorised into three groups: positive, negative, and other psychopathological symptoms. The statistical analysis comprised modalities such as demographic data, clinical symptoms, as well as neuroimaging scans linking them to a potential impact of sustaining the mentioned groups of symptoms during the period of hospitalization. The analysis revealed that statistically significant risk factors of persistence of the three groups of symptoms are the elderly age, the increasing toll of hospitalizations, suicidal attempts in medical history, a family history of alcohol abuse, the presence of positive, negative and other psychopathological symptoms on admission to the hospital, as well as the absence of cavum septi pellucidi (CSP). The study showed that addiction to psychotropic drugs and a family history of schizophrenia were more frequent in patients with persistent CSP.

Is deep brain stimulation effective in Huntington's Disease? - a systematic literature review.

INTRODUCTION: Huntington's Disease (HD) is an autosomal dominant neurodegenerative disorder. Substantial for a diagnosis of the disease are motor disorders, with chorea as a hallmark symptom. Other disease manifestations include cognitive dysfunction and psychiatric disorders. Currently, pharmacological treatment plays the most important role in the therapy of HD patients. However, deep brain stimulation (DBS) is considered a potential therapeutic option. AIM OF THE STUDY: Systematic review of current literature on DBS efficacy and safety in the management of motor, behavioural and cognitive functions in patients with HD. MATERIAL AND METHODS: A systematic review was conducted with the use of the Scopus database and the following search criteria: TITLE (huntington*) AND TITLE-ABS-KEY ('deep brain stimulation' OR 'neuromodulation'). Our search criteria included original studies with at least five patients, reporting any motor, cognitive and/or behavioural, and functional assessment data with at least a 6-month follow-up. Finally, four selected publications were analysed. RESULTS: In all analysed publications, we found a statistically significant improvement of Unified Huntington's Disease Rating Scale (UHDRS) chorea subscore by an average of 40, to over 60% after DBS implantation. Heterogeneous results were obtained for UHDRS total motor score. DBS did not improve functional capacity of HD patients in the analysed studies. We found no systematic assessment concerning the effect of DBS in HD on behaviour, cognition or speech. CONCLUSIONS: DBS implantation could be considered as a therapeutic option for patients with severe, drug-resistant chorea. However, the evidence for this is limited. To date, no high-quality data based on randomised controlled trials supports the long-term safety and efficacy of DBS in HD. This treatment option should therefore currently be considered as investigational.

Vascular Complications After Simultaneous Pancreas and Kidney Transplantation: A Case Report.

A 51-year-old patient with type I diabetes and end-stage renal disease was qualified for a simultaneous kidney and pancreas transplant. The procedure was performed in a typical manner: arterial anastomosis to the right common iliac artery, the graft's portal vein with inferior vena cava, and side-to-side duodenal intestinal anastomosis. The kidney was implanted retroperitoneally. Six months after the transplant, the patient reported pain in the right lower abdomen, and imaging examinations revealed arterial anastomosis. Reconstruction of the right common iliac artery was performed with a Gore-Tex prosthesis and the pancreatic artery reanastomosed to the right external iliac artery. After the surgery, the function of the transplanted pancreas deteriorated, the level of C-peptide was decreased, and the patient required low doses of insulin. After another 8 months, the imaging studies revealed an aneurysm located in the bifurcation of the aorta up to the anastomosis of the pancreatic graft artery with the iliac artery. The patient was qualified for the implantation of an endovascular of 2 prosthesis, which improved the graft's function. After another 2 months, the presence of an aneurysm at the endovascular prosthesis was found again. The patient was requalified for endovascular prosthesis implantation. Currently, there is no aneurysm but the function of the pancreas graft is impaired, though the kidney graft function is good. Patients after simultaneous kidney and pancreas transplant are a group of patients with an increased risk of vascular complications. Treatment should take place in a multidisciplinary center.

Impact of COVID-19 on pancreatic cancer surgery: A high-volume Polish center experience.

BACKGROUND: A total of 148 surgeries were performed in our center on patients with pancreatic cancer in 2020. In 2019, 263 such procedures were performed (77.7% more) in this facility. OBJECTIVES: To analyze the impact of coronavirus disease 2019 (COVID-19) on pancreatic cancer surgery type, number and outcome in our center. MATERIAL AND METHODS: Retrospective data analysis of medical documentation in a hospital database from January 2019 till December 2020. RESULTS: In 2020, we observed an increase of tumors localized in the tail of the pancreas (P) - 29 cases (19.9%) in 2020 compared to 26 cases (9.9%) in 2019 (p = 0.005). In 2020, our patients presented with much greater advancement of the disease illustrated by the increased tumor size (median 3.5 cm in 2020 compared to 3.0 cm in 2019), although it did not reach statistical significance (p = 0.073). In 2020, we performed more palliative procedures, e.g., bypassing anastomoses (17 (11.6%) in 2020 compared to 8 (3%) in 2019 (p < 0.001)), more open biopsies of P (21 (14.4%) in 2020 compared to 21 (7.9%) in 2019 (p = 0.041)), and more percutaneous biopsies of P (7 (4.8%) in 2020 and 0 in 2019 (p = 0.001)). We observed a significant decrease in the number of Whipple procedures (53 (36.3%) in 2020 and 125 (47.5%) in 2019 (p = 0.037)). The most common histopathological finding was adenocarcinoma of the P, accounting for 50% in 2020 and almost 52% of all tumor cases in 2019. In a group of 148 patients operated on due to a P tumor during the COVID-19 pandemic, only 6 patients died, which resulted in a mortality rate of 4.1% compared to 13.4% mortality rate in 2019 (34 deaths/263 patients; p = 0.005). We observed less leakage of gastrointestinal anastomosis (0/148 in 2020 and 10/263 in 2019 (p = 0.038)). CONCLUSIONS: Particular attention should be paid to patients with an aggressive type of cancer who have completed neoadjuvant therapy, as they are unable to undergo other therapeutic options. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive cancer patients should be postponed until recovery. Relatively few postoperative complications and low all-cause mortality are the result of a more careful selection of oncological patients before the admission to the surgical ward, as well as a ompliance with the principles of planning the procedure and organization of the operating theater during the COVID-19 pandemic.

Volume changes of medial temporal lobe structures in patients with genetic generalized and temporal lobe epilepsy in relation to neuropsychological functions.

Purpose: In patients with epilepsy (PWE), cognitive and behavioural dysfunctions are associated with abnormalities in various brain areas. The aim of the study was to compare the volume of the hippocampus (VHIP), amygdala (VAMG) and parahippocampal gyrus (VPHG) with the results of neuropsychological assessment in patients with temporal lobe epilepsy (TLE) and genetic generalized epilepsy (GGE). Methods: 33 PWE were enrolled in the study (mean age 37.3), 10 with TLE and 23 GGE (12 with GGE with tonic-clonic seizure [GGE-GTCS], and 11 with juvenile myoclonic epilepsy). 19 healthy persons (mean age 32.2) were enrolled as the control group (CG). Measurements of VHIP, VAMG and VPHG were made with 3D completely balanced steady state (CBASS) and 3D T1-weighted sequence. All participants underwent a neuropsychological assessment using a multi-domain cognitive battery and emotional state questionnaires. Results: The left hippocampus was significantly smaller in patients with left TLE (LTLE) and with GGE-GTCS, compared to the CG (p = 0.0069). In LTLE a significant enlargement of the right amygdala in comparison to the CG and other types of epilepsy were found (p = 0.0015). Among patients with LTLE and GGE-GTCS, impairment of attention and executive functions was statistically more common than in the CG. VHIP right (r = 0.25 p < 0.01) and VHIP left (r = 0.26 p < 0.04) were positively correlated with phonetic verbal fluency. Conclusions: PWE showed changes in the volume of selected medial temporal lobe (MTL) structures. Selective impairment of attention and executive functions was found. Some neuropsychological findings correlate with volume changes in MTL structures. Antiseizure medications therapy could have an impact on the severity of neuropsychological dysfunctions.

Technology and Properties of Peripheral Laser-Welded Micro-Joints.

This article presents the results of research on the technology and peripheral properties of laser-welded micro-couplings. The aim of this research was to determine the characteristics of properly made joints and to indicate the range of optimal parameters of the welding process. Thin-walled AISI 316L steel pipes with diameters of 1.5 and 2 mm used in medical equipment were tested. The micro-welding process was carried out on a SISMA LM-D210 Nd:YAG laser. The research methods used were macroscopic and microscopic analyses of the samples, and assessment of the distribution of elements in the weld, the distribution of microhardness and the tear strength of the joint. As a result of the tests, the following welding parameters are recommended: a pulse energy of 2.05 J, pulse duration of 4 ms and frequency of 2 Hz, beam focusing to a diameter of 0.4 mm and a rotation speed of 0.157 rad/s. In addition, the tests show good joint properties with a strength of more than 75% of the thinner pipe, uniform distribution of alloying elements and a complex dendritic structure characteristic of pulse welding.

The twisted structure of the fetal calcaneal tendon is already visible in the second trimester.

INTRODUCTION: The progress in morphological science results from the greater possibilities of intra-pubic diagnosis and treatment of congenital disabilities, including the motor system. However, the structure and macroscopic development of the calcaneal tendon have not been investigated in detail. Studies on the adult calcaneal tendon showed that the calcaneal tendon is composed of twisted subtendons. This study aimed to investigate the internal structure of the fetal calcaneal tendon in the second trimester. MATERIALS AND METHODS: Thirty-six fetuses fixed in 10% formaldehyde were dissected using the layer-by-layer method and a surgical microscope. RESULTS: The twisted structure of the calcaneal tendon was revealed in all specimens. The posterior layer of the calcaneal tendon is formed by the subtendon from the medial head of the gastrocnemius muscle. In contrast, the anterior layer is formed by the subtendon from the lateral head of the gastrocnemius muscle. The subtendon from the soleus muscle constitutes the anteromedial outline of the calcaneal tendon. The lateral outline of the calcaneal tendon is formed by the subtendon originating from the medial head of the gastrocnemius muscle. In contrast, the medial outline is formed by the subtendon from the soleus muscle. In most of the examined limbs, the plantaris tendon attached to the tuber calcanei was not directly connected to the calcaneal tendon. CONCLUSIONS: The twisted structure of the subtendons of the fetal calcaneal tendon is already visible in the second trimester and is similar to that seen in adults.

Psychometric properties of the polish version of the Alcohol Use Disorders Identification Test (AUDIT).

BACKGROUND: Alcohol consumption is one of the risk factors associated with over 200 types of diseases, being strongly correlated with unemployment, low socioeconomic status, traffic accidents, and violence. Alcohol is also one of the main causes of premature deaths, especially among males. Early diagnosis based on screening may help to prevent the evolution from alcohol misuse to dependence by counseling or treatment. METHODS: 1024 participants took part in the study: 300 of alcohol dependents and 724 of controls (405 students and 319 patients from General Practice) (M ± SD age = 33.7 ± 15.4 years). Finally, group of 877 participants were included to the statistical analysis due to the missing data - 453 were male and 424 were female. The median AUDIT score was 17 (IQR = 11). RESULTS: Correlation analysis showed that AUDIT scores were strongly correlated with MAST (rho = 0.764, p < 0.001) and CAGE scores (rho = 759, p < 0.001). The ROC analysis resulted in an area under the curve (AUC) of 0.95 (p < 0.001; 95 % C.I.: 0.936-0.963). The cutoff point of 22 for alcohol dependence corresponded to a sensitivity of 0.893 and a specificity of 0.863. CONCLUSION: According to our results, the AUDIT scale proved to be a useful tool with high sensitivity and specificity and therefore can be used as a valid screening measure in Poland.

Synthesis of Highly Oxygenated Bicyclic Carbasugars. Remarkable Difference in the Reactivity of the d-gluco and d-xylo- Derived Trienes.

2,3,4-Tri-O-benzyl-D-xylopyranose was used as a starting material in the preparation of the corresponding triene, which underwent smooth cyclization to a polyhydroxylated hydrindane, as a single diastereoisomer. The analogous triene prepared from D-glucose did not undergo any cyclization even under high pressure.

Hybrid simulation of pediatric gynecologic examination: a mix-methods study of learners' attitudes and factors affecting learning.

BACKGROUND: Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low. That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable, and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination, a high-fidelity hybrid simulation workshop was implemented in our institution. METHODS: The study aimed to investigate learners' attitudes towards the high-fidelity simulation (HFS) hybrid model as compared with task trainer-SP (simulated patient)-voice model in the HFS environment and the factors connected to learners' attitudes towards the hybrid model that could influence learning in high-fidelity simulation (HFS). The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews). RESULTS: Residents valued the HFS hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS. Further analysis of the themes allowed to develop a conceptual model, in which six factors connected to attitude components influenced learning. These factors were: task difficulty, attention, emotional realism of the simulation, patient's emotions, physical realism of the simulation, and technical issues. CONCLUSIONS: Participants of our study appreciated learning experience with the HFS hybrid model more, based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.

A case of acute pancreatitis - does step-up protocol always indicated?

Acute pancreatitis (AP) is still one of the most frequent cause of hospitalization. Grading severity of AP due to revised Atlanta classification differentiate: mild, moderately severe and severe AP. Mortality ranges from occasional tomild,8% in moderate, 36%-59% in severe AP. A CASE REPORT: 59-year-old man was hospitalized due to severe acute pancreatitis. Biliary duct obstruction was determined as a reason of AP and intensive treatment was started. The CT scan showed infected post-inflammatory pancreatic cyst. For this reason, endoscopic drainage of the pancreatic cyst to the stomach was performed first and then Jurasz operation. Severe postoperative course required treatment in the Intensive Care Unit (ICU). During the next hospitalization due to the patient's condition deterioration, endoscopic cyst drainage was performed again. Because of ineffectiveness of the performed treatment, the patient was reoperated. Post-operative multi-organ failure, lack of response to the intensive therapy and cachexia because of long-lasting illness, lead into patient's death. CONCLUSIONS: This case demonstrates problem with severe complications of AP which despite of multidisciplinary treatment combining endoscopy, surgery and pharmacology can finally lead to death.

Alterations in transcranial sonography among Huntington's disease patients with psychiatric symptoms.

Transcranial sonography (TCS) is a diagnostic tool in mood and movement disorders. Alterations within the raphe mesencephalic nucleus in the brain have been reported not only in patients with major depression but in patients with depressive symptoms accompanying several neurodegenerative disorders. The aim of the study was to assess the echogenicity of the nucleus raphe and other basal ganglia in patients with Huntington's disease (HD). TCS was performed in 127 HD patients participating in observational studies (Registry/Enroll-HD) in the Institute of Psychiatry and Neurology (Warsaw, Poland). Raphe hypoechogenicity was found in 78% of HD patients with current symptoms of depression (according to DSM-IV criteria), 57% of patients with a previous history of depression, and 56.8% patients who lacked signs or history of depression. Patients with hypoechogenic raphe reported significantly higher depression as measured on the BDI (15.6 ± 1.7) as compared to patients with normal echogenicity (9.5 ± 1.2), (p = 0.023). The diameter of the third ventricle was negatively correlated with Mini-Mental State Examination (MMSE) (rho - 0.37) and total functional capacity (TFC) scores (rho - 0.26). Hyperechogenic substantia nigra was visualized in 66,4% patients with HD and the degree of hyperechogenicity was correlated with the total motor score (TMS) (rho - 0.38). Changes in echogenicity of the basal ganglia are related to both depressive and motor symptoms among patients with HD.

Endovascular Treatment of Pseudoaneurysm After Simultaneous Pancreas-Kidney Transplant: A Case Report.

Pseudoaneurysm is a rare vascular complication in pancreas transplantation that can lead into life-threatening situations. A 44-year-old male patient after simultaneous pancreas-kidney transplant was admitted to the hospital for routine tests 3 months after surgery. A computed tomography scan and ultrasound examination were done, and a diagnosis of pseudoaneurysm was made. The patient was qualified for endovascular treatment. The pseudoaneurysm was closed using coils, and kidney and pancreas grafts stayed in proper condition. Endovascular interventions in patients after pancreas transplantation are safe and preferable in managing postoperative complications.

Prevalence of Non-psychiatric Comorbidities in Pre-symptomatic and Symptomatic Huntington's Disease Gene Carriers in Poland.

Huntington's disease (HD) is monogenic neurodegenerative disorder caused by CAG expansions within the Huntingtin gene (Htt); it has a prevalence of 1 in 10,000 worldwide and is invariably fatal. Typically, healthy individuals have fewer than 35 CAG repeats, while the CAG expansions range from 36 to ~200 in HD patients. The hallmark of HD is neurodegeneration, especially in the striatal nuclei, basal ganglia and cerebral cortex, leading to neurological symptoms that involve motor, cognitive, and psychiatric events. However, HD is a complex disorder that may also affect peripheral organs, so it is possible that HD patients could be affected by comorbidities. Hence, we investigated the prevalence of comorbid conditions in HD patients (pre-symptomatic and symptomatic groups) and compared the frequency of those conditions to a control group. Our groups represent 65% of HD gene carriers registered in Poland. We identified 8 clusters of comorbid conditions in both HD groups, namely: musculoskeletal, allergies, cardiovascular, neurological, gastrointestinal, thyroid, psychiatric, and ophthalmologic. We found that HD patients have a significantly higher percentage of co-existing conditions in comparison to the control group. Among the 8 clusters of diseases, musculoskeletal, psychiatric, and cardiovascular events were significantly more frequent in both pre- and symptomatic HD patients, while neurological and gastrointestinal clusters showed significantly higher occurrence in the HD symptomatic group. A greater recognition of comorbidity in HD might help to better understand health outcomes and improve clinical management.

Numerical and Metallurgical Analysis of Laser Welded, Sealed Lap Joints of S355J2 and 316L Steels under Different Configurations.

This paper presents the results of laser welding of dissimilar joints, where low-carbon and stainless steels were welded inthe lap joint configuration. Performed welding of austenitic and ferritic-pearlitic steels included a sealed joint, where only partial penetration of lower material was obtained.The authors presented acomparative study of the joints under different configurations. The welding parameters for the assumed penetration were estimated via anumericalsimulation. Moreover, a stress-strain analysis was performed based on theestablished model. Numerical analysis showed significant differences in joint properties, therefore, further study was conducted. Investigation of the fusion mechanism in the obtained joints wascarried out using electron dispersive spectroscopy (EDS) and metallurgical analysis. The study of the lap joint under different configurations showed considerable dissimilarities in stress-strain distribution and relevant differences in the fusion zone structure. The results showed advantages of using stainless steel as the upper material of a microstructure, and uniform chemical element distribution and stress analysis is considered.

Neuroma (schwannoma). A rare pancreatic tumor.

INTRODUCTION: Neuroma (Schwannoma in Latin) is an encapsulated, mesenchymal tumor arising from Schwann cells surrounded by nerves. Hence it can be located in any area in the body with passing peripheral nerves. The most common location is the head, neck, and extremities. The tumor arising from Schwannoma cells was first described by Stout and Carson in 1935. Pancreatic schwannomas are extremely rare tumors. Until 2017, in English literature 68 cases have been described. Surgical treatment is the most common way of treating pancreatic schwannomas, and postoperative prognoses are good. CASE REPORT: A 63-year-old patient was admitted to the Clinical Department of Gastroenterological Surgery and Transplantation of the Central Clinical Hospital at the Ministry of Interior and Administration in Warsaw due to pancreatic head cancer. Needle biopsy-both ultrasound-guided and CT-guided as well as open biopsy for lesions in the pancreas did not show tumor cells in any of the collected samples. Abdominal CT in a projection of the uncinate process of the pancreas revealed an oval lesion highly suspected of neoplastic process. Next, diagnostics was extended by abdominal MRI which revealed a retroperitoneal tumorous thick-walled cystic mass filled with fluid. The patient was qualified for surgical treatment. Pancreaticoduodenectomy (Whipple Procedure) was done on August 22, 2017. Material sent for histopathological examination revealed Schwannoma capitis pancreatis. In surgical practice, pancreatic schwannoma occurs extremely rare, but in centers which conduct large numbers of surgical procedures in the pancreas, a case like this may occur.