Gastric Schwannoma: A Postoperative Surprise A Case Report.

Gastric Schwannoma is a rare, slow-growing, and clinically non-specific submucosal tumor, originating from Schwann cells with excellent prognosis after surgical resection. We report a clinical case of a patient presented with gastric schwannoma revealed by non-specific gastric signs and of which the definitive diagnosis is done through immunohistochemistry of the resected specimen, showing strong S100 protein positivity. The evolution is favorable after a partial gastrectomy with a decline of two years. Through this case, we are trying to trace the rarity, strong similarities with gastric stromal tumors and especially, the weak index of suspicion for this diagnosis.

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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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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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Gastric Schwannoma: A Case Report and Review of the Literature for Gastric Submucosal Masses Distinction

Case Reports in Medicine ◽

10.1155/2018/1230285 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Behnam Sanei ◽

Amirhosein Kefayat ◽

Melika Samadi ◽

Parvin Goli ◽

Mohammad Hossein Sanei ◽

...

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Rare Case ◽

Outlet Obstruction ◽

Accurate Diagnosis ◽

Review Of The Literature ◽

Stromal Tumors ◽

Gastric Schwannoma ◽

Frequent Vomiting ◽

Submucosal Mass ◽

Slow Growing

Schwannomas origin from Schwann cells sheath and generally are benign, slow-growing, and asymptomatic neoplasms which frequently appear in the head and neck. Although gastrointestinal schwannoma is really rare, the most affected organ in GI system is the stomach. Gastric schwannoma forms 0.2% of all gastric tumors. This neoplasm is always detected as a submucosal mass, the same as other gastrointestinal stromal tumors. Although these tumors have almost the same presentations, they are completely different at therapeutic options and prognoses. Hence, it is important to distinguish them apart and make an accurate diagnosis to optimize treatment outcomes. Herein, we report a case of 28-year-old woman with frequent vomiting and abdominal pain caused by 5 × 6 cm schwannoma in the antrum of the stomach. This is a rare case of gastric outlet obstruction due to a massive schwannoma. In addition, all other probable submucosal masses will be discussed at different aspects.

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Case Report: Schwannoma of the sigmoid colon: a case report of a rare colonic neoplasm and review of literature

F1000Research ◽

10.12688/f1000research.19110.1 ◽

2019 ◽

Vol 8 ◽

pp. 652

Author(s):

Gangmi Kim ◽

Sun Il Kim ◽

Kang Young Lee

Keyword(s):

Case Report ◽

Sigmoid Colon ◽

Tumor Cells ◽

Surgical Resection ◽

Submucosal Tumor ◽

Regional Lymph Node ◽

Screening Colonoscopy ◽

Resection Margins ◽

Resected Specimen ◽

S 100

Background: Schwannomas are tumors originating in Schwann cells of the peripheral nerve system and uncommonly develop in the gastrointestinal tract. Sigmoid colon schwannomas are very rare and only 28 cases have been reported. This study aims to report a case of a sigmoid colon schwannoma and present a literature review. Case report: We report a case of a 66-year-old female with asymptomatic sigmoid colon schwannoma. The patient underwent a screening colonoscopy and about 4cm sized submucosal tumor was identified at the sigmoid colon. A colonoscopic biopsy was performed and the microscopic exam revealed an ulcerated lesion with a proliferation of fibroblast-like spindle cells beneath ulcer, which was insufficient for diagnosis. Abdominopelvic computerized tomography (CT) scan showed a well-defined, well-enhancing, round shaped and slightly heterogenous mass at the sigmoid colon. No distant metastasis was identified in abdominopelvic CT and chest CT scans. Carcinoembryonic antigen level was within a normal range (1.33ng/mL). The patient underwent laparoscopic anterior resection. Immunohistochemical staining of the resected specimen showed positivity for S-100 protein in tumor cells and schwannoma was diagnosed post-surgically. Surgical resection margins were free from tumor and no regional lymph node metastasis was reported. Conclusion: Colon schwannomas are rare diseases. Most cases of colon schwannomas are accidentally identified during screening colonoscopy. The tumors usually present as submucosal masses and colonoscopic biopsies are mostly non-diagnostic. Surgical resection is required, and definitive diagnosis is made by confirming S-100 positive tumor cells in immunohistochemical analysis. Most cases are benign; a few cases have been reported to be malignant. Surgical resection with free negative margins is the treatment of choice

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A rare simultaneous coexistence of epithelioid gastrointestinal stromal tumors and schwannoma in the stomach: a case report

Diagnostic Pathology ◽

10.1186/s13000-019-0898-x ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Yuxin Li ◽

Yongliang Teng ◽

Xiaofei Wei ◽

Zhuang Tian ◽

Yuqing Cao ◽

...

Keyword(s):

Case Report ◽

Tumor Cells ◽

Gastrointestinal Stromal Tumors ◽

Simultaneous Occurrence ◽

Correct Identification ◽

Stromal Tumors ◽

Gastric Schwannoma ◽

Disease Pattern ◽

S 100 ◽

Lesser Curvature

Abstract Background Gastrointestinal stromal tumors (GISTs), a type of mesenchymal tumor in the gastrointestinal tract, are believed to be closely associated with PDGFRA and C-KIT mutations. Schwannoma in the stomach, which is an unusual location, is a rare disorder. The simultaneous occurrence of the two diseases is rarer than metachronous occurrences, and its pathological characteristics have not been reported to date. We present a case report on a patient with simultaneous coexistence of gastric schwannoma and GISTs. Case presentation A 39-year-old female visited our hospital complaining of intermittent abdominal pain for the previous 3 months. CT revealed a 3.4 cm slight homogeneous enhancement in the lesser curvature of the stomach; the mass was nodular soft tissue, which was removed by radical surgery. Two solid tumors with different volumes were located in the stomach. Histologically and immunohistochemically different, the larger tumor consisted of spindle cells surrounded by a peripheral lymphoid cuff, and was positive for S-100. The larger tumor was therefore classified as a gastric schwannoma. The smaller tumor was composed of medium-sized round, oval cells with amphiphilic granular cytoplasm; vacuolization was also observed. The tumor cells were positive for DOG1 and sporadically positive for CD34 and CD117. Hence, the smaller tumor was diagnosed as epithelioid GISTs. Sanger sequencing revealed that the GIST tumor cells contained a deletion mutation (c.2527_2538 del12,843–846del4), which was located in exon 18 of PDGFRA. Conclusion GISTs combined with gastric schwannoma are a considerably rare subgroup of gastric tumors. Related clinical research is comparatively weak, and the mechanism remains unknown. We reviewed related articles to provide knowledge to improve the correct identification, diagnosis and management of patients with gastric cancer. All pathologists involved in the diagnosis and clinicians involved in the treatment should be aware of this new kind of disease pattern to improve their understanding of the disease.

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Gastric Schwannoma mimicking gastrointestinal stromal tumors: a rare case with review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20201899 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1691

Author(s):

Nagari Bheerappa ◽

Digvijoy Sharma ◽

Gangadhar Rao Gondu ◽

Nirjhar Raj ◽

Kamal Kishore Bishnoi ◽

...

Keyword(s):

Differential Diagnosis ◽

Gastrointestinal Stromal Tumors ◽

Malignant Potential ◽

Review Of Literature ◽

Mesenchymal Tumors ◽

Submucosal Tumors ◽

Stromal Tumors ◽

Gastric Schwannoma ◽

Gastric Mass ◽

Slow Growing

Gastric schwannoma (GS) is a rare neoplasm of the stomach. It accounts for 0.2% of all gastric tumors and is mostly benign, slow-growing, and asymptomatic. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors and up to 60-70% of GIST occur in the stomach. Schwannoma and GIST have similar radiological and endoscopic features making it extremely difficult to differentiate them preoperatively. Differential diagnosis of these two submucosal tumors is important because of the malignant potential of GIST and the relatively benign course of gastric schwannomas. This case stresses on the importance of including gastric schwannomas in the differential diagnosis of a submucosal gastric mass as it has the ability to mimic a gastrointestinal stromal tumor, which is a leading differential diagnosis because of its common occurrence at this site.

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Gastric Wall Implantation of Pancreatic Cancer Due to Preoperative Endoscopic Ultrasound-Guided Fine Needle Aspiration: A Case Report

International Surgery ◽

10.9738/intsurg-d-17-00039.1 ◽

2020 ◽

Vol 104 (3-4) ◽

pp. 171-175

Author(s):

Hiromitsu Maehira ◽

Masao Ogawa ◽

Masayasu Kawasaki ◽

Atsuo Imagawa ◽

Ken Yuu ◽

...

Keyword(s):

Pancreatic Cancer ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Submucosal Tumor ◽

Gastric Wall ◽

Partial Gastrectomy ◽

Needle Aspiration ◽

Resected Specimen ◽

Ultrasound Guided ◽

Fine Needle

Introduction: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is often used to diagnose pancreatic tumors. In rare cases, preoperative EUS-FNA can be complicated by gastric wall implantation of pancreatic cancer. Case presentation: A 66-year-old woman with pancreatic tail cancer underwent evaluation by EUS-FNA, followed by distal pancreatectomy and splenectomy. Twelve months postoperatively, a submucosal tumor was detected at the posterior gastric wall, at the location where the EUS-FNA was performed, and a boring biopsy from the submucosal tumor showed an adenocarcinoma. Therefore, we performed partial gastrectomy. Immunostaining results of the resected specimen were identical to those of the resected pancreatic cancer. The patient was diagnosed as having gastric wall implantation of pancreatic cancer due to EUS-FNA. Conclusion: This case emphasizes the importance of monitoring the site of EUS-FNA for gastric wall implantation of pancreatic cancer, and boring biopsy is a useful diagnostic tool.

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Ossifying Fibroma of the Maxilla: A Case Report and Literature Update

Surgical Case Reports ◽

10.31487/j.scr.2021.09.08 ◽

2021 ◽

pp. 1-4

Author(s):

Abdouldaim Ukwas ◽

Mohammed Magdy ◽

Mahmoud Elshik

Keyword(s):

Case Report ◽

Female Patient ◽

Bone Grafting ◽

Fibrous Tissue ◽

Definitive Diagnosis ◽

Ossifying Fibroma ◽

Normal Bone ◽

Calcified Tissues ◽

Slow Growing ◽

Normal Bone Tissue

Ossifying fibroma is a rare benign fibro-osseous neoplasm of the jaw characterized by the replacement of normal bone tissue by a combination of fibrous tissue and newly formed calcified tissues of bone and/or cementum-like material. Lesions often manifest at the 2nd to 4th decades of life with a predominant female predilection. The tumor is usually slow-growing and asymptomatic but can cause notable expansion of the jawbones. Definitive diagnosis of OF can be challenging and usually requires careful clinical, radiographic and histologic assessments. Treatment commonly depends on the size, location and aggressiveness of tumor and can accordingly vary from enucleation and curettage to resection and bone grafting. The prognosis is generally good when the lesion is completely removed, but recurrence is possible in some circumstances. The aim of this article is to present a case report of a recurrent ossifying fibroma in a 28-year-old female patient and to provide an update of the literature.

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