Introduction. Schwannomas are rare benign tumors of the gastrointestinal
tract. Despite the differences in features of schwannomas located in the
stomach as opposed to peripheral or soft tissue schwannomas, their
immunohistochemical characteristics are the same. We present a case of a
14-month-old boy with a gastric tumor who underwent a combined
laparoscopic-endoscopic resection surgery, followed by gastric schwannoma
diagnosis. Case outline. The patient was admitted to our pediatric hospital
with a fever of unknown origin. Endoscopy, performed after recurrent
hematemesis, revealed an ulcer in the gastric antrum. At the four-week
follow-up, gastroscopic and microscopic findings were normal. Two weeks
later, a flank mass in the antrum was detected by an ultrasound examination.
A new gastroscopy and CT scan confirmed the presence of a tumor-like mass, 5
cm in diameter. A combined laparoscopic-endoscopic polypectomy was performed
with a necessary conversion for complete resection of tumor. The initial
histological findings were consistent with a gastrointestinal stromal tumor.
Due to this tumor?s rarity in childhood, the paraffin-embedded tissue
samples were referred for a second opinion. Histological and
immunohistochemical characteristics of the tumor made the gastrointestinal
stromal tumor diagnosis unlikely and consistent with a completely resected
gastric schwannoma. No recurrence of the disease occurred during the
seven-year follow-up. Conclusion. Combined laparoscopic-endoscopic surgery
is a feasible and effective treatment for large gastric tumors that cannot
be excised endoscopically. Schwannoma should be included in the differential
diagnostic consideration of gastric tumor lesions even in childhood.
Gastric schwannoma: a benign tumor often misdiagnosed as gastrointestinal stromal tumor
