A Rare Case of Gastric Schwannoma: A Case Report and Literature Review

In general, schwannoma is a benign and slow-glowing neoplasm that rarely occurs in the gastrointestinal tract as a submucosal tumor (SMT), with the most common site being the stomach. As gastric schwannoma (GS) is a rare tumor, there is limited data in the literature about its clinical features. The diagnosis of schwannoma can only be made by pathological examination with positive staining for S-100 protein. It is necessary to obtain an accurate diagnosis to introduce optimal treatment options preoperatively. However, a precise diagnosis of GS is difficult, even with modern imaging techniques. On the other hand, a complete resection with a negative surgical margin (R0) of GS is considered the best treatment, with an excellent prognosis. We present a case of a 66-year-old female patient who underwent laparoscopic-assisted wedge gastrectomy for gastric SMT, pathologically diagnosed as GS, with positive staining for S-100 protein and negative for c-kit and CD34. At 12-month follow-up after surgery, there was no recurrence or metastasis of GS. Our treatment is appropriate and effective in case of GS exceeding 50 mm.

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A Case of Benign Schwannoma of the Ascending Colon Treated With Laparoscopic-Assisted Wedge Resection

International Surgery ◽

10.9738/intsurg-d-13-00015.1 ◽

2013 ◽

Vol 98 (4) ◽

pp. 315-318 ◽

Cited By ~ 7

Author(s):

Se-Jin Baek ◽

Won Hwangbo ◽

Jin Kim ◽

In-Sun Kim

Keyword(s):

Submucosal Tumor ◽

Wedge Resection ◽

Ascending Colon ◽

Mesenchymal Tumors ◽

Benign Schwannoma ◽

S 100 ◽

Colon And Rectum ◽

Laparoscopic Assisted ◽

Specific Symptoms ◽

Diffuse Positivity

Abstract Isolated colonic schwannomas are rare gastrointestinal mesenchymal tumors. Only a small number of cases have been reported. Occurrence of these tumors is more common in the stomach than in the large intestine. These spindle cell lesions are distinct from leiomyoma, leiomyosarcoma, and gastrointestinal stromal tumors because the tumor cells have a distinct immunophenotype, with strong diffuse positivity for S-100 and vimentin, as well as corroborative negative staining of CD117 and smooth muscle markers. We present a case of colonic schwannoma in a 70-year-old woman who had no specific symptoms. The patient was diagnosed with a submucosal tumor in the ascending colon on colonoscopy and abdominal computed tomography. Laparoscopic-assisted wedge resection of colon was performed. The very rare pathologic diagnosis of ascending schwannoma was made postoperatively. This case is interesting because schwannomas of the colon and rectum are extremely rare and are treated by laparoscopic-assisted wedge resection.

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Phakomatous Choristoma of the Eyelid and Orbit: A Case Report

Pediatric and Developmental Pathology ◽

10.1177/1093526619882136 ◽

2019 ◽

Vol 23 (4) ◽

pp. 296-300

Author(s):

Seyed Mohsen Rafizadeh ◽

Hadi Ghadimi ◽

Zohreh Nozarian

Keyword(s):

Smooth Muscle Actin ◽

Surgical Excision ◽

Lower Eyelid ◽

Medium Size ◽

Positive Staining ◽

Orbital Mass ◽

Precise Diagnosis ◽

S 100 ◽

The Right ◽

Histopathologic Findings

Phakomatous choristoma was first described as a distinct pathologic entity by Zimmerman in 1971. Report of only 26 cases of this tumor so far is an indicator of the rarity of phakomatous choristoma. We present a 4-month-old infant with an orbital mass beneath the right lower eyelid. Surgical excision was undertaken and the histopathologic findings of a dense fibrocollagenous stroma containing small to medium size islands and glandular-like structures surrounded by thick basement membrane and filled by amorphous eosinophilic material confirmed the diagnosis. Immunohistochemical study showed positive staining for S-100 and vimentin and negative staining for cytokeratins, glial fibrillary acidic protein, smooth muscle actin, synaptophysin, CD34, melan-A, and epithelial membrane antigen markers. This is the first patient with phakomatous choristoma presented from our country and the 27th reported case worldwide. Phakomatous choristoma is a rare, benign congenital tumor of lenticular anlage, almost always presenting in the medial lower eyelid and anterior orbit. Surgical excision is curative and allows precise diagnosis due to the unique histopathologic and immunostaining characteristics of this choristoma.

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Amelanotic Metastatic Gastric Malignant Melanoma: A Case Report

10.21203/rs.3.rs-127891/v1 ◽

2020 ◽

Author(s):

Min Min ◽

Zhang Daya ◽

Zhang Guanjun ◽

Wang Zhanbo ◽

mingyang Li

Keyword(s):

Malignant Melanoma ◽

Clinical Manifestations ◽

Amelanotic Melanoma ◽

Pathological Examination ◽

Positive Staining ◽

Melanoma Metastasis ◽

S 100 ◽

Cutaneous Form ◽

Tumor Metastases ◽

Melanoma Patients

Abstract BackgroundMelanoma is a cutaneous form of disease with an increasing incidence since 1970s, especially in western countries, accounting for nearly 75% of the death related to skin cancer. Clinical outcome varies a lot among different subtypes, and highest recurrence and mortality were observed within the type with distal metastasis. Furthermore, high incidence of gastrointestinal (GI) metastasis of malignant melanoma is frequently misdiagnosed due to lack of specific clinical manifestations. Amelanotic melanoma metastasis, especially the gastrointestinal metastasis, was rarely observed in clinical practice, accounting for only about 2% of all metastatic cases.Case presentationIn the present study, we report a 36-year-old male patient with gastric cancer, who was diagnosed as amelanotic melanoma by Immunohistochemical (IHC) staining, demonstrating positive staining for melanoma markers including Melan A, S-100, Hmb45 and CD79a.ConclusionsIn conclusion, for the colorless tumor metastases found during gastroscopy in melanoma patients, detailed pathological examination should be carried out in combination with previous medical history to determine the nature of the tumor and treatment regime.

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Preoperatively diagnosed gastric collision tumor with mixed adenocarcinoma and gastrointestinal stromal tumor: a case report and literature review

Clinical Journal of Gastroenterology ◽

10.1007/s12328-021-01343-4 ◽

2021 ◽

Author(s):

Kunihiko Matsuno ◽

Yoshikazu Kanazawa ◽

Daisuke Kakinuma ◽

Nobutoshi Hagiwara ◽

Fumihiko Ando ◽

...

Keyword(s):

Gastrointestinal Stromal Tumor ◽

Distal Gastrectomy ◽

Submucosal Tumor ◽

Smooth Muscle Actin ◽

Collision Tumor ◽

Stromal Tumor ◽

Lower Body ◽

Muscle Actin ◽

First Case ◽

S 100

AbstractReports of gastric collision tumors, comprising adenocarcinoma and gastrointestinal stromal tumor, are extremely rare. Here, we report the case of a 68-year-old male who was diagnosed with a lower-body, moderately differentiated, tubular-type adenocarcinoma and submucosal tumor and underwent an elective D2 distal gastrectomy. The tumor cells of the gastrointestinal stromal tumor were positive for H-caldesmon and CD117, weakly positive for smooth muscle actin and DOG-1, and negative for desmin, S-100 protein, CD31, and AE1/AE3. The tumor had grown into a mixed form of adenocarcinoma and gastrointestinal stromal tumor. Thus, we report the first case of a preoperatively diagnosed collision tumor in the stomach consisting of adenocarcinoma and gastrointestinal stromal tumor.

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Mesenteric Cysts: A Retrospective Review. Its Not All That Simple

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.257 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S117-S118

Author(s):

M Bourgeau ◽

V Avadhani

Keyword(s):

Cyst Wall ◽

Imaging Techniques ◽

Case Reports ◽

Lymphatic Vessels ◽

Mucinous Cystadenoma ◽

Final Diagnosis ◽

Cystic Mass ◽

Pathological Examination ◽

Urachal Cyst ◽

Mesenteric Cysts

Abstract Introduction/Objective Mesenteric cysts are rare intra-abdominal lesions in adults. However, with the advanced imaging techniques and laparoscopic techniques, they are more often being identified and resected when clinically significant. There is a lack of detailed information in histopathology (except as case reports) since mesentery is generally neglected in our organ-based textbooks. The aim of our study is to highlight the importance of identifying and classifying mesenteric cystic lesions; they are not all that simple. Methods We performed a retrospective search on all mesenteric cysts submitted as excisions in our electronic database from 2013-2019. We classified them as per the de Perrot (PMID: 11053936) classification with modification. Results Our search showed: A. Lymphatic origin-11 (lymphangioma-10, Lymphangioma hamartomatous-1, associated with LAM-0), B. Mesothelial origin-68 (Benign mesothelial cysts-57, multilocular mesothelial cyst-11), C. Enteric origin- 3, D. Urogenital origin (Urachal cyst, mullerian inclusion cyst)-9, E. Mature cystic teratom-2, F. Pseudocyst-12, G. Epithelial cyst (not urogenital)- 11 (a/w LAMN-3, MCN-4, Mucinous cystadenoma-4), H. Associated with carcinoma-2. Case illustration: A 61-year-old male presented with worsening dysphagia, emesis and hiccups. A CT scan showed a 21.2 cm cystic mass with at least one septation (Fig 1). The cyst was resected. On gross pathological examination, the cyst measured 18 cm in greatest dimension with a thick, rough, tan-brown capsule. Microscopic examination showed a fibrous capsule, and cyst wall composed of numerous lymphatic vessels (CD31 positive) and prominent smooth muscle proliferation (Desmin positive). Scattered lymphoid aggregates were also present throughout the cyst wall. No definite epithelial lining was identified and was suspected to have been denuded. HMB-45 immunostain was negative, ruling out association with LAM. The final diagnosis of a Lymphangiomyoma, hamartomatous was rendered. Conclusion Though most of the mesenteric cysts are benign, some of them are significantly important such as Lymphangiomyoma (esp secondary to LAM), MCN, those associated with LAMN etc. and identifying and differentiating from their mimics has distinct clinical implications.

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Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

Case Reports in Surgery ◽

10.1155/2012/280982 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

William Yoon ◽

Kari Paulson ◽

Paul Mazzara ◽

Sweety Nagori ◽

Mohammed Barawi ◽

...

Keyword(s):

Differential Diagnosis ◽

Surgical Resection ◽

Treatment Options ◽

Partial Gastrectomy ◽

Preoperative Imaging ◽

Mesenchymal Tumors ◽

Gastric Schwannoma ◽

Gastric Mass ◽

Submucosal Mass ◽

Slow Growing

Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

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Gynecology Meets Big Data in the Disruptive Innovation Medical Era: State-of-Art and Future Prospects

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105058 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5058

Author(s):

Rola Khamisy-Farah ◽

Leonardo B. Furstenau ◽

Jude Dzevela Kong ◽

Jianhong Wu ◽

Nicola Luigi Bragazzi

Keyword(s):

Big Data ◽

Information And Communication Technologies ◽

Imaging Techniques ◽

Treatment Options ◽

Wearable Sensors ◽

Three Dimensional ◽

Disruptive Innovation ◽

Healthcare Management ◽

The Internet ◽

Big Data Visualization

Tremendous scientific and technological achievements have been revolutionizing the current medical era, changing the way in which physicians practice their profession and deliver healthcare provisions. This is due to the convergence of various advancements related to digitalization and the use of information and communication technologies (ICTs)—ranging from the internet of things (IoT) and the internet of medical things (IoMT) to the fields of robotics, virtual and augmented reality, and massively parallel and cloud computing. Further progress has been made in the fields of addictive manufacturing and three-dimensional (3D) printing, sophisticated statistical tools such as big data visualization and analytics (BDVA) and artificial intelligence (AI), the use of mobile and smartphone applications (apps), remote monitoring and wearable sensors, and e-learning, among others. Within this new conceptual framework, big data represents a massive set of data characterized by different properties and features. These can be categorized both from a quantitative and qualitative standpoint, and include data generated from wet-lab and microarrays (molecular big data), databases and registries (clinical/computational big data), imaging techniques (such as radiomics, imaging big data) and web searches (the so-called infodemiology, digital big data). The present review aims to show how big and smart data can revolutionize gynecology by shedding light on female reproductive health, both in terms of physiology and pathophysiology. More specifically, they appear to have potential uses in the field of gynecology to increase its accuracy and precision, stratify patients, provide opportunities for personalized treatment options rather than delivering a package of “one-size-fits-it-all” healthcare management provisions, and enhance its effectiveness at each stage (health promotion, prevention, diagnosis, prognosis, and therapeutics).

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Gastric schwannoma: a case report

Clinics and Practice ◽

10.4081/cp.2016.849 ◽

2016 ◽

Vol 6 (4) ◽

Cited By ~ 3

Author(s):

Hayfa Romdhane ◽

Myriam Cheikh ◽

Zeineb Mzoughi ◽

Sana Ben Slama ◽

Rym Ennaifer ◽

...

Keyword(s):

Epigastric Pain ◽

Submucosal Tumor ◽

Muscularis Propria ◽

Partial Gastrectomy ◽

Gastric Antrum ◽

Submucosal Tumors ◽

Gastric Schwannoma ◽

One Year ◽

Immunohistochemical Studies ◽

Enhanced Computed Tomography

Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis <em>via</em> endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal. Biopsy specimens yielded only unspecific signs of mild inactive chronic inflammation. Endoscopic ultrasound examination noted a hypoechoic homogeneous mass lesion located in the gastric antrum. The mass appeared to arise from the muscularis propria, and there was no perigastric lymphadenopathy. A contrast-enhanced computed tomography scan identified a homogeneous round mass and arising from the antrum of the stomach. Submucosal tumor was suspected and surgical intervention was recommended. The patient underwent an elective laparoscopic partial gastrectomy. The histopathologic features and immunohistochemical-staining pattern were consistent with a benign gastric schwannoma. Our patient shows no recurrence with a follow-up of one year. The definitive diagnosis of gastric schwannomas requires immunohistochemical studies. Complete margin negative surgical resection, as in this case, is the curative treatment of choice. The clinical course is generally benign.

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Melanosis of the Uterine Cervix: A Rare Case Report

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49943.15187 ◽

2021 ◽

Author(s):

Nikhil Sanjay Deshpande ◽

Aditi Mittal ◽

Anil B Munemane ◽

Ravindra Raosaheb Karle

Keyword(s):

Uterine Cervix ◽

Histopathological Examination ◽

Basal Layer ◽

Pathological Finding ◽

Final Diagnosis ◽

Pathological Examination ◽

Macular Lesion ◽

Melanocytic Lesions ◽

Rare Case Report ◽

S 100

Cervical melanosis is a rare entity in the spectrum of melanocytic lesions of uterine cervix. Melanosis is defined as presence of melanocytes in the basal layer of squamous epithelium causing hyperpigmentation. Authors here by report a case of 57-year-old female who underwent vaginal hysterectomy for third degree utero-vaginal prolapse, showed an incidental gross pathological finding of brownish macular lesion. Histopathological examination showed hyperpigmentation of basal layer without increase in melanocytes. On immunohistochemical examination, basal melanocytes were highlighted by S-100 and HMB 45 immunostains. Thus final diagnosis of cervical melanosis was made. Clinical differentials of cervical pigmented melanocytic lesions include cervical melanomas, blue nevi, congenital or traumatic lesions and melanosis, hence vigilant clinical, gross pathological examination and biopsy is warranted.

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Right Heart Phenotype in Heart Failure With Preserved Ejection Fraction

Circulation Heart Failure ◽

10.1161/circheartfailure.120.007840 ◽

2021 ◽

Author(s):

Marco Guazzi ◽

Robert Naeije

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Right Ventricular ◽

Ventricular Dysfunction ◽

Imaging Techniques ◽

Treatment Options ◽

Right Ventricular Dysfunction ◽

Preserved Ejection Fraction ◽

Right Heart ◽

The Right

The health burden of heart failure with preserved ejection fraction is increasingly recognized. Despite improvements in diagnostic algorithms and established knowledge on the clinical trajectory, effective treatment options for heart failure with preserved ejection fraction remain limited, mainly because of the high mechanistic heterogeneity. Diagnostic scores, big data, and phenomapping categorization are proposed as key steps needed for progress. In the meantime, advancements in imaging techniques combined to high-fidelity pressure signaling analysis have uncovered right ventricular dysfunction as a mediator of heart failure with preserved ejection fraction progression and as major independent determinant of poor outcome. This review summarizes the current understanding of the pathophysiology of right ventricular dysfunction in heart failure with preserved ejection fraction covering the different right heart phenotypes and offering perspectives on new treatments targeting the right ventricle in its function and geometry.

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